Статті в журналах: "Lateral decompression"

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Sweeney, Adam R., Solomon S. Shaftel, Sarah M. Jacobs, and Arash Jian-Amadi. "Lateral Wall Orbital Decompression." Journal of Craniofacial Surgery 28, no. 2 (March 2017): 379–82. http://dx.doi.org/10.1097/scs.0000000000003299.

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Frankel, Joshua, and Angela Hitch. "Deep Lateral Wall Decompression." American Journal of Ophthalmology 142, no. 2 (August 2006): 352. http://dx.doi.org/10.1016/j.ajo.2006.03.035.

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Welch, Julie L., and Nicholas Saltarelli. "Tension pneumothorax: Lateral needle decompression." Visual Journal of Emergency Medicine 10 (January 2018): 118–19. http://dx.doi.org/10.1016/j.visj.2017.11.022.

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Nakashima, Hiroaki, Tokumi Kanemura, Kotaro Satake, Kenyu Ito, Yoshimoto Ishikawa, Jun Ouchida, Naoki Segi, Hidetoshi Yamaguchi, and Shiro Imagama. "Indirect Decompression Using Lateral Lumbar Interbody Fusion for Restenosis after an Initial Decompression Surgery." Asian Spine Journal 14, no. 3 (June 30, 2020): 305–11. http://dx.doi.org/10.31616/asj.2019.0194.

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Study Design: Retrospective comparative study.Purpose: We compared clinical and radiographical outcomes after lumbar decompression revision surgery for restenosis by lateral lumbar interbody fusion (LLIF) and posterior lumbar interbody fusion (PLIF).Overview of Literature: Indirect lumbar decompression with LLIF was used to treat degenerative lumbar diseases requiring neural decompression. However, only a few studies have focused on the effectiveness of this technique for restenosis after lumbar decompression.Methods: We retrospectively investigated 52 cases involving lumbar interbody fusions for restenosis with spondylolisthesis after lumbar decompressions; these cases consisted of 15 patients who underwent indirect decompression with LLIF and posterior fixation and 37 patients who underwent the same procedure with PLIF. We compared Japanese Orthopaedic Association (JOA) scores and perioperative complications between groups. The cross-sectional areas of the thecal sac on magnetic resonance imaging were measured before, immediately after, and 2 years after surgery. We conducted statistical analyses using unpaired t -test and Fisher’s exact tests, and a p -value <0.05 was considered statistically significant.Results: The operative time was significantly shorter in the LLIF group than in the PLIF group (115.3±33.6 min vs. 186.2±34.2 min, respectively; p <0.001). In addition, the intraoperative blood loss was significantly lower in the LLIF group than in the PLIF group (58.2±32.7 mL vs. 303.2±140.1 mL, respectively; p <0.001). We found two cases of transient lateral thigh weakness (13.3%) in the LLIF group and five cases of incidental durotomy, one case of deep infection, and one case of neurological deterioration in the PLIF group—resulting in a higher complication incidence (18.9%), although it did not reach (p =0.63). The JOA scores improved significantly in both groups.Conclusions: Indirect decompression using LLIF provided acceptable clinical and radiographical outcomes in patients with restenosis with spondylolisthesis after lumbar decompression; no revision-surgery-specific complications were found. Our results suggest that LLIF is a safe and minimally invasive procedure for revision surgery.

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Hanna, Amgad. "Transposition of the lateral femoral cutaneous nerve." Journal of Neurosurgery 130, no. 2 (February 2019): 496–501. http://dx.doi.org/10.3171/2017.8.jns171120.

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OBJECTIVEMeralgia paresthetica causes pain, burning, and loss of sensation in the anterolateral thigh. Surgical treatment traditionally involves neurolysis or neurectomy of the lateral femoral cutaneous nerve (LFCN). After studying and publishing data on the anatomical feasibility of LFCN transposition, the author presents here the first case series of patients who underwent LFCN transposition.METHODSNineteen patients with meralgia paresthetica were treated in the Department of Neurological Surgery at University of Wisconsin between 2011 and 2016; 4 patients underwent simple decompression, 5 deep decompression, and 10 medial transposition. Data were collected prospectively and analyzed retrospectively. No randomization was performed. The groups were compared in terms of pain scores (based on a numeric rating scale) and reoperation rates.RESULTSThe numeric rating scale scores dropped significantly in the deep-decompression (p = 0.148) and transposition (p < 0.0001) groups at both the 3- and 12-month follow-up. The reoperation rates were significantly lower in the deep-decompression and transposition groups (p = 0.0454) than in the medial transposition group.CONCLUSIONSBoth deep decompression and transposition of the LFCN provide better results than simple decompression. Medial transposition confers the advantage of mobilizing the nerve away from the anterior superior iliac spine, giving it a straighter and more relaxed course in a softer muscle bed.

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Fayers, Tessa, Lucy E. Barker, David H. Verity, and Geoffrey E. Rose. "Oscillopsia after Lateral Wall Orbital Decompression." Ophthalmology 120, no. 9 (September 2013): 1920–23. http://dx.doi.org/10.1016/j.ophtha.2013.01.063.

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Wulc, Allan E., Jeffrey C. Popp, and Scott P. Bartlett. "Lateral Wall Advancement in Orbital Decompression." Ophthalmology 97, no. 10 (October 1990): 1358–69. http://dx.doi.org/10.1016/s0161-6420(90)32409-0.

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Jönsson, Bo, and Björn Strömqvist. "Decompression for Lateral Lumbar Spinal Stenosis." Spine 19, no. 21 (November 1994): 2381–86. http://dx.doi.org/10.1097/00007632-199411000-00001.

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Fiss, Ingo, Dorothee Mielke, Veit Rohde, Marios Psychogios, and Christoph Schilling. "Correlation between different instrumentation variants and the degree of destabilization in treating cervical spondylotic spinal canal stenosis by unilateral hemilaminectomy with bilateral decompression: a biomechanical investigation." European Spine Journal 30, no. 6 (March 10, 2021): 1529–35. http://dx.doi.org/10.1007/s00586-021-06773-9.

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Abstract Purpose Unilateral hemilaminectomy with bilateral decompression (BDZ) was proposed as an alternative decompressive procedure in cervical spondylotic myelopathy (CSM). Despite promising clinical results, the destabilizing effect is yet unknown. We therefore performed a biomechanical study to investigate whether lateral mass screw fixation should follow BDZ. Methods Six human C2–C7 cervical specimens were tested under various conditions: native, unilateral hemilaminectomy with bilateral decompression without/with fixation (BDZ/BDF), unilateral hemilaminectomy with bilateral decompression and unilateral foraminotomy without/with fixation (UFZ/UFF), unilateral hemilaminectomy with bilateral decompression and bilateral foraminotomy without/with fixation (BFZ/BFF), and laminectomy without/with fixation (LAZ/LAF). Instrumention was applied from C3–C6. For each condition, the three-dimensional kinematics of the cervical specimen were measured in three main loading directions with an ultrasonic motion analysis system. ANOVA was used to determine differences between the specific segment conditions to assess the parameter’s range of motion (ROM) and neutral zone (NZ). Results For flexion–extension, lateral bending and axial rotation, ROM of BDZ, UFZ, BFZ and LAZ remained at the level of the native condition (p > 0.74), whereas fixation reduced ROM significantly (p < 0.01). Between BDF, UFF, BFF and LAF, no significant differences in reduction in ROM were seen (p > 0.49). Results for NZ were equivalent to ROM in flexion–extension and lateral bending. For axial rotation, NZ remained almost constant on the native level for all tested conditions. Conclusion Bilateral decompression via a hemilaminectomy, even if combined with foraminotomy, could be a less invasive treatment option for multilevel CSM in patients with lordotic cervical alignment and absence of segmental instability.

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Amorim, Marcela Maria de Almeida, Bruno Martins Araújo, and Eduardo Alberto Tudury. "Partial thoracolumbar lateral corpectomy in dogs and cats – review." Clínica Veterinária XXI, no. 120 (January 1, 2016): 76–88. http://dx.doi.org/10.46958/rcv.2016.xxi.n.120.p.76-88.

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Intervertebral disk disease is one of the most common neurological conditions in dogs; thoracolumbar disk is a usual cause of neurological dysfunction in this species. Several clinical and surgical treatments have been described, ranging from acupuncture and confinement to the use of anti-inflammatory, analgesic and muscle relaxant drugs, as well as the employment of varied surgical decompression techniques. The partial thoracolumbar lateral corpectomy is an alternative and effective surgical technique to treat chronic and acute thoracolumbar disk disease. It allows adequate access to the floor of the spinal canal for removal of disc material with minimal handling of the spinal cord, allowing wide and effective decompression. This review deals with anatomical, surgical and biomechanical aspects of this technique, and discusses its indications, advantages and disadvantages.

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Park, Daehyun, Praveen V. Mummaneni, Ratnesh Mehra, Yonguk Kwon, Sungtae Kim, Hui Bing Ruan, and Dean Chou. "Predictors of the need for laminectomy after indirect decompression via initial anterior or lateral lumbar interbody fusion." Journal of Neurosurgery: Spine 32, no. 6 (June 2020): 781–87. http://dx.doi.org/10.3171/2019.11.spine19314.

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OBJECTIVEThe goal of this study was to evaluate factors that are associated with the need for additional posterior direct decompressive surgery after anterior lumbar interbody fusion (ALIF) or lateral lumbar interbody fusion (LLIF).METHODSEighty-six adult patients who underwent ALIF or LLIF for degenerative spondylolisthesis and foraminal stenosis were enrolled. Patient factors (age, sex, number of surgery levels, and visual analog scale [VAS] score for leg and back pain); procedure-related factors (cage height and lordosis); and radiographic measurements (disc height [DH]; foraminal height [FH], foraminal area [FA], central canal diameter [CCD], and facet joint degeneration [FD]) were analyzed. All patients underwent staged surgery on 2 different days, with the anterior portion first, followed by the posterior portion.RESULTSOf 86 patients, 62 underwent posterior decompression and 24 had no posterior decompression. There were no significant differences between groups with regard to age, sex, preoperative VAS score for back pain, cage height, cage angulation, preoperative DH, FH, FA, CCD, and FD (p > 0.05). The group that underwent posterior decompression showed statistically different numbers of treated segments (1.92 vs 1.21, p < 0.01), preoperative VAS leg score (7.9 vs 6.3), symptom duration (14.2 months vs 9.4 months), postoperative DH improvement (61.3% vs 96.2%), postoperative FH improvement (21.5% vs 32.1%), postoperative FA improvement (24.1% vs 36.9%), and cage height minus preoperative DH (5.3 mm vs 7.5 mm) compared with the nondecompression group.CONCLUSIONSThere appears to be some correlation between the need for posterior decompression and the number of treated segments, VAS leg scores, symptom duration, FH, FA, and difference between the cage height and preoperative DH. In selected patients undergoing staged surgery, indirect decompression without direct decompression may be a reasonable option in treating degenerative spinal conditions.

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Ha, Jerome How Ing, James Leong, Peter Martin, Raf Ghabrial, and Ross Benger. "Outcomes following orbital decompression surgery for dysthyroid optic neuropathy associated with Graves’ ophthalmopathy." Asian Journal of Ophthalmology 14, no. 3 (August 4, 2015): 97–107. http://dx.doi.org/10.35119/asjoo.v14i3.138.

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Purpose: To investigate the outcomes of orbital decompression surgery for dysthyroid optic neuropathy associated with severe Graves’ ophthalmopathy. Design: Ten years (2000-2010) retrospective case series.Methods: Thirty-eight orbits (with dysthyroid optic neuropathy) of 119 surgical orbital decompressions. Patients with dysthyroid optic neuropathy associated with Graves’ ophthalmopathy, who underwent orbital decompression surgery at Sydney Eye Hospital (Sydney, Australia), were investigated for outcome measures.Results: Thirty-five orbits were eligible for data analysis. Orbital decompression surgery improved visual acuity in 29 orbits and maintained visual acuity in four orbits. In patients with dysthyroid optic neuropathy, there was a statistically significant mean improvement in visual acuity of 2.8 lines postoperatively (standard deviation = 3.2; 95% confidence interval 3.9 to 1.7, p-value < 0.05). There were no statistically significant differences invisual acuity amongst different combinations of orbital walls being decompressed, with the majority of orbits had the medial orbital wall decompressed. This may reflect the small number of decompressions performed in each subgroup. Orbital decompression surgery reduced proptosis by a mean of 3.2 mm (standard deviation = 2.9; 95% confidence interval -4.32 to -2.07; p-value < 0.05). Medial and lateral orbital walls decompression resulted in the greatest mean reduction in proptosis. There were no severe visual impairment cases postoperatively (VA worse than 6/60). There were two patients with new onset diplopia postoperatively. There were three orbits with bleeding and one orbit with CSF leakage, all without major sequelae postoperatively.Conclusion: Regardless of surgical access, orbital decompression surgery is effective and safe in the management of dysthyroid optic neuropathy and in reducing proptosis in patients with Graves’ ophthalmopathy.

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Kambin, Parviz, Kenneth Casey, Evan O'Brien, and Linqui Zhou. "Transforaminal arthroscopic decompression of lateral recess stenosis." Journal of Neurosurgery 84, no. 3 (March 1996): 462–67. http://dx.doi.org/10.3171/jns.1996.84.3.0462.

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✓ The purpose of this study was to evaluate the feasibility and efficacy of arthroscopic decompression of lateral recess stenosis, determine potential associated complications, and present an alternative method to access the lateral recess of the lumbar spine. Forty patients were selected in whom the authors found clinical and computerized tomography evidence of lateral recess stenosis and sequestered foraminal herniations. All 40 were treated with a posterolateral arthroscopic technique, and 38 were available for this follow-up evaluation. A satisfactory result was obtained in 31 patients (82%). No neurovascular complications were encountered; however, other complications included an infection of the disc space in one patient and a causalgic-type pain in the involved extremity in four patients. The associated postoperative morbidity in this group of patients was minimal and resulted in rapid rehabilitation and return of patients to preoperative functioning level.

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Agarwala, Sanjay, and Anshul Shyam Sobti. "Lateral Wall Decompression for Malunited Calcaneal Fractures." Journal of Foot and Ankle Surgery (Asia Pacific) 2, no. 2 (2015): 80–85. http://dx.doi.org/10.5005/jp-journals-10040-1035.

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ABSTRACT Aim The purpose of this case series is to reintroduce Kashiwagi decompression as a viable treatment option for malunited calcaneal fractures, delineate the operative technique, and discuss its advantages. Materials and methods From August 2004 to May 2013, 18 patients with Sanders type I malunited calcaneal fractures with lateral heel pain and impingement were treated with the lateral wall decompression technique. The functional outcome was assessed using the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale. Results Eleven patients were males and seven were females, with an average age of 48.4 years. Ten patients had left feet fracture and eight had right feet fracture. Among all the 18 patients with a ‘poor’ score at baseline, 2 (11.11%) scored ‘excellent’, 11 (61.11%) scored ‘good’ and 3 (16.67%) scored ‘fair’ during postoperative evaluation. The average time to return to daily activities was 10.2 weeks (8–12.5 weeks). Conclusion Lateral wall osteotomy and decompression effectively addresses the pathology in cases of lateral abutment due to a malunited calcaneal fracture. This technique has advantages of ensuring a reliable resolution with good clinical outcomes and produces fewer postoperative complications. Clinical significance Malunion is a common complication with calcaneal fracture. It affects normal function. In malunited calcaneal fractures, the lateral wall of the calcaneum forms a lateral wall exostosis that causes both subfibular impingement and peroneal tendinopathy or displacement. There is need for a viable treatment option for malunions with lateral wall exostosis after calcaneal fractures. This study describes a surgical technique as a solution for the above. How to cite this article Agarwala S, Sobti AS. Lateral Wall Decompression for Malunited Calcaneal Fractures. J Foot Ankle Surg (Asia-Pacific) 2015;2(2):80-85.

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Patel, B. C. K. "Stereotactic navigation for lateral orbital wall decompression." Eye 23, no. 7 (July 2009): 1493–95. http://dx.doi.org/10.1038/eye.2009.25.

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Braly, W. Grant, John O. Bishop, and Hugh S. Tullos. "Lateral Decompression for Malunited Os Calcis Fractures." Foot & Ankle 6, no. 2 (October 1985): 90–96. http://dx.doi.org/10.1177/107110078500600207.

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Nineteen heels in 19 patients underwent a lateral decompression for hindfoot pain secondary to a malunited os calcis fracture with subtalar intra-articular involvement. The operative procedure consisted of a lateral calcaneal bony prominence removal (ostectomy) and sural nerve release or transection. In addition, the peroneal tendons were released, relocated, and lengthened as necessary, with repair or reconstuction of their retinaculum. Eight patients (group I) had previously undergone a late subtalar fusion without relief of lateral symptoms. Eleven patients (group II) underwent a lateral decompression as an alternative to late subtalar fusion. In both groups combined, there were 14 males and 5 females with an average age of 40 years. The average follow-up was 28 months in group I and 17 months in group II. A satisfactory result was obtained in 75% (6 of 8) of the patients in group I and in 82% (9 of 11) of the patients in group II. This compares to a published success rate of approximately 50% in selected series in the literature and the authors' similar success rate of 46% for late subtalar fusion for the same pathology. The results suggest that the lateral decompression procedure offers a technically simpler yet effective alternative to late subtalar fusion for lateral pain following a malunited os calcis fracture with subtalar intra-articular involvement.

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Enyo, Yoshio, Hiroshi Yamada, Jung H. Kim, Munehito Yoshida, and William C. Hutton. "Microendoscopic Lateral Decompression for Lumbar Foraminal Stenosis." Journal of Spinal Disorders and Techniques 27, no. 5 (July 2014): 257–62. http://dx.doi.org/10.1097/bsd.0b013e31828cff6e.

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Ramesh, Sathyadeepak, Knut Eichhorn, Steven Leibowitz, and Robert Goldberg. "Bony Regrowth After Deep Lateral Orbital Decompression." Ophthalmic Plastic and Reconstructive Surgery 34, no. 6 (2018): 533–35. http://dx.doi.org/10.1097/iop.0000000000001076.

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Sellari-Franceschini, S., R. Lenzi, A. Santoro, L. Muscatello, R. Rocchi, M. A. Altea, M. Nardi, L. Megna, and C. Marcocci. "Lateral wall orbital decompression in Graves’ orbitopathy." International Journal of Oral and Maxillofacial Surgery 39, no. 1 (January 2010): 16–20. http://dx.doi.org/10.1016/j.ijom.2009.10.011.

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Landriel, Federico, Santiago Hem, and Claudio Yampolsky. "Lateral Transpsoas Approach for Lumbar Indirect Lateral Recess Decompression: 2-Dimensional Operative Video." Operative Neurosurgery 16, no. 3 (July 17, 2018): 391. http://dx.doi.org/10.1093/ons/opy156.

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Abstract Neurogenic claudication is a common symptom of lumbar spinal stenosis; its pathophysiology is thought to be ischemia of the nerve roots secondary to compression from surrounding structures. The stenosis of the lateral recesses and neuroforamen can cause these symptoms and its surgical treatment is decompression. The placement of interbody cages that restore the disc space height may indirectly decompress the neuroforamen and alleviate the nerve impingement symptoms. In case of concomitant low-grade spondylolisthesis, interbody devices might also reduce the slippage. We present a technical surgical video of a minimally invasive lateral transpsoas fusion, relying on indirect decompression to treat a patient with neurogenic claudication secondary to grade 1 spondylolisthesis. The patient signed a written consent to publish a video, recording, photograph, image, illustration, and/or information about him.

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Sellari-Franceschini, Stefano, Stefano Berrettini, Amelia Santoro, Marco Nardi, Salvatore Mazzeo, Luigi Bartalena, Barbara Mazzi, Maria Laura Tanda, Claudio Marcocci, and Aldo Pinchera. "Orbital Decompression in Graves' Ophthalmopathy by Medial and Lateral Wall Removal." Otolaryngology–Head and Neck Surgery 133, no. 2 (August 2005): 185–89. http://dx.doi.org/10.1016/j.otohns.2005.02.006.

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Objective The objective of this study is to describe a technique for balanced orbital decompression and to analyze the results. Methods and Materials We conducted a retrospective study of 140 patients (276 orbits). Orbital decompression was carried out by removal of the medial orbital wall by ethmoidectomy and complete removal of the lateral wall by bringing out the entire sphenoid wing together with part of the zygomatic bone down to the inferior orbital fissure. Results One hundred thirty-six patients underwent bilateral decompression, 4 patients underwent monolateral decompression. Proptosis was reduced on average by 5.3 mm; 28 (20%) patients showed onset or worsening of diplopia. Conclusions Medial and lateral approach allows a balanced orbital decompression. As some patients may present different degrees of proptosis and visual impairment, we stress the importance of carefully weighing the preoperative conditions of the individual patient when choosing the surgical approach.

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Shimizu, Takayoshi, Shunsuke Fujibayashi, Bungo Otsuki, Koichi Murata, and Shuichi Matsuda. "Indirect Decompression Through Oblique Lateral Interbody Fusion for Revision Surgery After Lumbar Decompression." World Neurosurgery 141 (September 2020): e389-e399. http://dx.doi.org/10.1016/j.wneu.2020.05.151.

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Bengoa-González, Álvaro, Alicia Galindo-Ferreiro, Enrique Mencía-Gutiérrez, Hortensia Sánchez-Tocino, Agustín Martín-Clavijo, and María-Dolores Lago-Llinás. "Deep Lateral Wall Partial Rim-Sparing Orbital Decompression with Ultrasonic Bone Removal for Treatment of Thyroid-Related Orbitopathy." Journal of Ophthalmology 2019 (December 2, 2019): 1–10. http://dx.doi.org/10.1155/2019/9478512.

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Purpose. To describe the results of thyroid-related orbitopathy (TRO) treated by ultrasonic deep lateral wall bony decompression with partial rim sparing (DLW-PRS). Methods. A review was carried out, from January 2015 to September 2017, of all patients treated with ultrasonic DLW-PRS decompression using a SONOPET® (Stryker, Kalamazoo, MI, USA) ultrasonic aspirator, using a lateral, small triangle flap incision for access. The primary outcome was the change in proptosis (measured by the difference in Hertel exophthalmometry measurements). Other secondary outcomes were changes in visual acuity (VA) (using Snellen scale, decimal fraction), presence of lagophthalmos, eyelid retraction (measured by upper eyelid margin distance to the corneal reflex (MRD1) and lower eyelid margin distance to the corneal reflex (MRD2), and presence of exposure keratopathy). Results. A total of 58 orbital decompressions in 35 patients were reviewed, with 23 patients (65.7%) having bilateral decompressions. There was a female preponderance with 26 patients (74.2%), and the mean age ± standard deviation was 52.6 ± 13.9 years. Mean proptosis was 24.51 ± 1.76 mm preoperatively, reduced to 19.61 ± 1.27 mm in final follow-up. The mean reduction was 4.9 ± 1.54 mm. VA improved from 0.8 ± 0.14 to 0.9 ± 0.12, p=0.039. 5 of 13 patients (38.4%) with preoperative diplopia reported improvement or complete resolution after surgery. MRD1 was reduced from 5.25 ± 0.88 mm to 4.49 ± 0.7 mm. MRD2 was also reduced from 6.3 ± 0.88 mm to 5.0 ± 0.17 mm. Presence of lagophthalmos was reduced from 35 eyes (60.3%) to five (8.6%); the presence of epiphora was also reduced from 20 patients (57.1%) to 3 (8.5%) following decompression. Complications of the surgery included zygomatic hypoaesthesia in 14 (40%) patients in the early postoperative period and chewing alterations in 10 (28.5%) of the patients. All of these complications were resolved at the 6-month follow-up visit. We noted no surgical complications such as ocular or soft tissue damage, infection, inflammation, or visual loss. Conclusions. The SONOPET® ultrasonic bone curette can be used safely and effectively for DLW orbital decompression surgery. The main benefits were good visualization and handling of tissues and speed and ease of use of the equipment. This trial is registered with ClinicalTrials.gov identifier: NCT04025034.

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Møller, Aage R., and Peter J. Jannetta. "Microvascular Decompression in Hemifacial Spasm: Intraoperative Electrophysiological Observations." Neurosurgery 16, no. 5 (May 1, 1985): 612–18. http://dx.doi.org/10.1227/00006123-198505000-00005.

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Abstract Facial muscle responses in patients with hemifacial spasm undergoing microvascular decompression operations were recorded. Two peripheral branches of the facial nerve were stimulated and the electrical responses of muscles innervated by these branches were studied to see how the lateral spread of activity that is known to be present in these patients was affected by decompressing the facial nerve. In some of the patients the hemifacial spasm ceased when the dura mater was opened, in some it ceased when the arachnoid was opened, and in others the spasm persisted until the offending vessel was dissected away from the nerve. The lateral spread of activity elicited by antidromic stimulation of a branch of the facial nerve was less affected by opening of the dura mater or arachnoid: it usually persisted until the blood vessel that had been compressing the facial nerve was removed and reappeared when the vessel that had been compressing the facial nerve was allowed to slip back onto the nerve. This seems to indicate that microvascular decompression of the facial nerve is effective in alleviating hemifacial spasm because it removes the actual cause of the disorder rather than simply causing local injury to the nerve as a result of the procedure.

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Khalsa, Siri Sahib S., Yamaan S. Saadeh, Timothy J. Yee, Michael J. Strong, Brandon W. Smith, and Mark E. Oppenlander. "Lumbar Lateral Recess Decompression: 2-Dimensional Operative Video." Operative Neurosurgery 19, no. 4 (May 23, 2020): E394. http://dx.doi.org/10.1093/ons/opaa134.

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Abstract Lateral recess stenosis is a common cause of lumbar radiculopathy in adults. A lumbar nerve root travels in the lateral recess prior to exiting the spinal canal via the neural foramen. In the lateral recess, the traversing nerve root is susceptible to compression by the degenerative hypertrophy of the medial facet in addition to hypertrophied ligamentum flavum and herniated intervertebral disc.1 These degenerative changes are also typically associated with neural foraminal stenosis. Surgical treatment in unilateral cases consists of hemilaminectomy, medial facetectomy, foraminotomy, and, if applicable, microdiscectomy. In this video, we present a case of a 64-yr-old male presenting with progressive left L5 radiculopathy refractory to conservative management, with magnetic resonance imaging (MRI) findings of left L4-5 foraminal and lateral recess stenosis. We demonstrate the operative steps to complete a left L4-5 hemilaminectomy, medial facetectomy, foraminotomy, and microdiscectomy. Appropriate patient consent was obtained.

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Kepler, Christopher K., Amit K. Sharma, Russel C. Huang, Dennis S. Meredith, Federico P. Girardi, Frank P. Cammisa, and Andrew A. Sama. "Indirect foraminal decompression after lateral transpsoas interbody fusion." Journal of Neurosurgery: Spine 16, no. 4 (April 2012): 329–33. http://dx.doi.org/10.3171/2012.1.spine11528.

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Object Lateral transpsoas interbody fusion (LTIF) permits anterior column lumbar interbody fusion via a direct lateral approach. The authors sought to answer 3 questions. First, what is the effect of LTIF on lumbar foraminal area? Second, how does interbody cage placement affect intervertebral height? And third, how does the change in foraminal area and cage position correlate with changes in Oswestry Disability Index (ODI) and 12-Item Short Form Health Survey (SF-12) scores? Methods Included patients underwent LTIF with or without posterior instrumentation and received preoperative and postoperative CT scans. Disc heights, neural foraminal area between adjacent-level pedicles, and anteroposterior cage position were measured from sagittal CT images. Preoperative and postoperative ODI and SF-12 scores were matched with the change in foraminal area from the clinically most severely affected side for analysis of the relationship between outcomes instruments and change in foraminal area. Results Average foraminal area increased by 36.2 mm2, or 35% of the preoperative area (p < 0.01), without statistically significant differences by side, level, or anteroposterior cage position. Preoperative anterior and posterior disc heights measured 6.2 mm and 3.7 mm, respectively, compared with postoperative measurements of 9.8 mm (p < 0.01) and 6.3 mm (p < 0.01), respectively, without significant differences by level or cage position. Despite significant overall improvement in ODI and SF-12 scores, there was no correlation with foraminal area increase. Conclusions Average foraminal area increased approximately 35% after cage placement without variation based on cage position. While ODI and SF-12 scores increased significantly, there was no significant association with cage position or foraminal area change, likely attributable to the multifactorial nature of preoperative pain.

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Silver, Robert D., George S. Goding, and Andrew R. Harrison. "Combined Endoscopic Medial and External Lateral Orbital Decompression." Otolaryngology–Head and Neck Surgery 131, no. 2 (August 2004): P212. http://dx.doi.org/10.1016/j.otohns.2004.06.402.

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Knox, Barton E., George A. Gates, and Susan M. Berry. "Optic Nerve Decompression Via the Lateral Facial Approach." Laryngoscope 100, no. 5 (May 1990): 458???462. http://dx.doi.org/10.1288/00005537-199005000-00003.

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Rubinstein, Tal J., and Valerie H. Chen. "Re: “Bony Regrowth After Deep Lateral Orbital Decompression”." Ophthalmic Plastic and Reconstructive Surgery 35, no. 2 (2019): 204–5. http://dx.doi.org/10.1097/iop.0000000000001325.

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Leone, Charles R., Ken L. Piest, and Richard J. Newman. "Medial and Lateral Wall Decompression for Thyroid Ophthalmopathy." American Journal of Ophthalmology 108, no. 2 (August 1989): 160–66. http://dx.doi.org/10.1016/0002-9394(89)90011-1.

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Kolotov, Ye B., R. R. Aminov, Ye V. Kolotova, V. V. Kelmakov, and N. M. Zhilina. "THE COMPARATIVE ASSESSMENT THE EFFECTIVENESS OF TREATMENT THE NERVE ROOT COMPRESS SYNDROME USING THE ANTERIOR AND POSTERIOR APPROACHES OF PATIENTS WITH COMBINED LATERAL LUMBAR STENOSIS." Bulletin of Siberian Medicine 12, no. 6 (December 28, 2013): 103–11. http://dx.doi.org/10.20538/1682-0363-2013-6-103-111.

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Objective: to compare the therapeutic possibility of the decompressiveviedecompressive with stabilization surgeries using the standard posterior and anterior retroperitoneal approaches in patients with combination of inherent and obtaining lateral stenosis and to demonstrate the adequacy of using. At the main group we removed the herniated disc with stabilization using anterior and posterior approaches – 82 patients. The control group was treated by standard microdiscectomy – 40 patients. More excellent and good results were in the main group where decompression was combined with stabilization, and at the same group were less negative results. The decompressive-stabilizing surgery with anterior interbody fusion is a pathogenetic and technically adequate treatment for combined lateral stenosis.

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Dangelmajer, Sean, Patricia L. Zadnik, Samuel T. Rodriguez, Ziya L. Gokaslan, and Daniel M. Sciubba. "Minimally invasive spine surgery for adult degenerative lumbar scoliosis." Neurosurgical Focus 36, no. 5 (May 2014): E7. http://dx.doi.org/10.3171/2014.3.focus144.

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Object Historically, adult degenerative lumbar scoliosis (DLS) has been treated with multilevel decompression and instrumented fusion to reduce neural compression and stabilize the spinal column. However, due to the profound morbidity associated with complex multilevel surgery, particularly in elderly patients and those with multiple medical comorbidities, minimally invasive surgical approaches have been proposed. The goal of this meta-analysis was to review the differences in patient selection for minimally invasive surgical versus open surgical procedures for adult DLS, and to compare the postoperative outcomes following minimally invasive surgery (MIS) and open surgery. Methods In this meta-analysis the authors analyzed the complication rates and the clinical outcomes for patients with adult DLS undergoing complex decompressive procedures with fusion versus minimally invasive surgical approaches. Minimally invasive surgical approaches included decompressive laminectomy, microscopic decompression, lateral and extreme lateral interbody fusion (XLIF), and percutaneous pedicle screw placement for fusion. Mean patient age, complication rates, reoperation rates, Cobb angle, and measures of sagittal balance were investigated and compared between groups. Results Twelve studies were identified for comparison in the MIS group, with 8 studies describing the lateral interbody fusion or XLIF and 4 studies describing decompression without fusion. In the decompression MIS group, the mean preoperative Cobb angle was 16.7° and mean postoperative Cobb angle was 18°. In the XLIF group, mean pre- and postoperative Cobb angles were 22.3° and 9.2°, respectively. The difference in postoperative Cobb angle was statistically significant between groups on 1-way ANOVA (p = 0.014). Mean preoperative Cobb angle, mean patient age, and complication rate did not differ between the XLIF and decompression groups. Thirty-five studies were identified for inclusion in the open surgery group, with 18 studies describing patients with open fusion without osteotomy and 17 papers detailing outcomes after open fusion with osteotomy. Mean preoperative curve in the open fusion without osteotomy and with osteotomy groups was 41.3° and 32°, respectively. Mean reoperation rate was significantly higher in the osteotomy group (p = 0.008). On 1-way ANOVA comparing all groups, there was a statistically significant difference in mean age (p = 0.004) and mean preoperative curve (p = 0.002). There was no statistically significant difference in complication rates between groups (p = 0.28). Conclusions The results of this study suggest that surgeons are offering patients open surgery or MIS depending on their age and the severity of their deformity. Greater sagittal and coronal correction was noted in the XLIF versus decompression only MIS groups. Larger Cobb angles, greater sagittal imbalance, and higher reoperation rates were found in studies reporting the use of open fusion with osteotomy. Although complication rates did not significantly differ between groups, these data are difficult to interpret given the heterogeneity in reporting complications between studies.

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Elisevich, Kost, Larry Allen, Uldis Bite, and Robert Colcleugh. "Decompression for dysthyroid ophthalmopathy via the orbital rim approach." Journal of Neurosurgery 80, no. 3 (March 1994): 580–83. http://dx.doi.org/10.3171/jns.1994.80.3.0580.

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✓ A technique is described wherein the approach to the orbital cavity, with resection of its roof and lateral wall, is facilitated by a single burr hole and local en bloc removal of the lateral and supraorbital margins. A satisfactory decompression with reduction of proptosis of the orbital contents and a good cosmetic result is achieved without the need for a large dural exposure. The approach may be combined with removal of the anterior wall of the frontal sinus in cases where the lateral aspect extends appreciably laterally. Access to the orbital roof and lateral wall is straightforward and can be coupled with further removal of the floor lateral to the infraorbital nerve and medial wall. Advancement of the orbital rim upon bone replacement adds to orbital volume, creating better mechanical advantage for eyelid closure.

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Nguyen, Austin Q., Jackson P. Harvey, Krishn Khanna, Bryce A. Basques, Garrett K. Harada, Frank M. Phillips, Kern Singh, Christopher Dewald, Howard S. An, and Matthew W. Colman. "Reasons for revision following stand-alone anterior lumbar interbody fusion and lateral lumbar interbody fusion." Journal of Neurosurgery: Spine 35, no. 1 (July 2021): 60–66. http://dx.doi.org/10.3171/2020.10.spine201239.

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OBJECTIVE Anterior lumbar interbody fusion (ALIF) and lateral lumbar interbody fusion (LLIF) are alternative and less invasive techniques to stabilize the spine and indirectly decompress the neural elements compared with open posterior approaches. While reoperation rates have been described for open posterior lumbar surgery, there are sparse data on reoperation rates following these less invasive procedures without direct posterior decompression. This study aimed to evaluate the overall rate, cause, and timing of reoperation procedures following anterior or lateral lumbar interbody fusions without direct posterior decompression. METHODS This was a retrospective cohort study of all consecutive patients indicated for an ALIF or LLIF for lumbar spine at a single academic institution. Patients who underwent concomitant posterior fusion or direct decompression surgeries were excluded. Rates, causes, and timing of reoperations were analyzed. Patients who underwent a revision decompression were matched with patients who did not require a reoperation, and preoperative imaging characteristics were analyzed to assess for risk factors for the reoperation. RESULTS The study cohort consisted of 529 patients with an average follow-up of 2.37 years; 40.3% (213/529) and 67.3% (356/529) of patients had a minimum of 2 years and 1 year of follow-up, respectively. The total revision rate was 5.7% (30/529), with same-level revision in 3.8% (20/529) and adjacent-level revision in 1.9% (10/529) of patients. Same-level revision patients had significantly shorter time to revision (7.14 months) than adjacent-level revision patients (31.91 months) (p < 0.0001). Fifty percent of same-level revisions were for a posterior decompression. After further analysis of decompression revisions, an increased preoperative canal area was significantly associated with a lower risk of further decompression revision compared to the control group (p = 0.015; OR 0.977, 95% CI 0.959–0.995). CONCLUSIONS There was a low reoperation rate after anterior or lateral lumbar interbody fusions without direct posterior decompression. The majority of same-level reoperations were due to a need for further decompression. Smaller preoperative canal diameters were associated with the need for revision decompression.

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Powell, Weston, and Maida Chen. "1237 Positional central sleep apnea in a child: not always obstructive." Sleep 43, Supplement_1 (April 2020): A472. http://dx.doi.org/10.1093/sleep/zsaa056.1231.

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Abstract Introduction Spinal cord compression at the craniocervical junction can cause central sleep apnea (CSA) in children, due to mechanical disruption of respiratory control centers. Polysomnography (PSG) pre/post surgical decompression is indicated to evaluate treatment response. Report of Case A 5-year-old with Wolf-Hirschhorn syndrome, developmental delay, partial agenesis of the corpus callosum, hypotonia, incomplete segmentation of C1 with subluxation leading to stenosis, cleft palate, and obstructive sleep apnea (OSA) presented for post-surgical PSG. Prior PSGs revealed oAHI 55/hr and 7/hr, cAHI 3/hr and 2/hr at 1 and 10 months of age, respectively. At 46 months, patient underwent suboccipital decompression at C1 for severe craniocervical stenosis. Post-operative PSG revealed emergence of CSA with cAHI 8/hr and stability of OSA with an oAHI 8/hr. Positional analysis revealed worsening in lateral position (lateral cAHI 10.6/hr, supine cAHI 4.6/hr). Central events were up to 33 seconds long with nadir desaturation of 76% in lateral position compared to 20 seconds and nadir 88% in supine position. Head CT and MRI showed incomplete ossification of the C1 vertebra with subluxation of the left lateral mass leading to absence of CSF flow at the craniocervical junction. Repeat decompression and fixation is planned by neurosurgery; in the interim supine sleep was recommended and family declined BiPAP. Conclusion In our case, CSA worsened with left lateral positioning and improved with supine positioning. Lateral positioning likely increased subluxation of the left lateral mass seen on CT/MRI, and eased subluxation in supine sleep causing position-dependent dynamic impingement of the respiratory control centers at the level of subluxation. The absence of findings prior to decompression may reflect increased instability after decompression or increased stenosis with growth. Our case highlights the importance of positional analysis for central as well as the more conventional obstructive sleep apnea to understand pathogenesis and guide therapy.

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Karki, Prasanna, Damber Bikram Shah, Sumit Joshi, Prakash Poudel, Jessica Kayastha, and Gopal Raman Sharma. "Microvascular Decompression using Muscle Graft for Vertebral Artery Medullary Compression Syndrome." Nepal Journal of Neuroscience 17, no. 3 (November 27, 2020): 55–58. http://dx.doi.org/10.3126/njn.v17i3.33128.

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It is well known that brainstem dysfunction may be caused by vascular compression of the medulla oblongata. However, only a limited number of reports have found microvascular decompression surgery to be an effective treatment for symptomatic patients with medulla oblongata dysfunction. This report describes a patient with vertebral artery compression of lateral medulla oblongata who presented with lateral medullary syndrome. Microvascular decompression surgery using the transcondylar fossa approach was effective in relieving patient symptoms. The transcondylar fossa approach and the transposition of vertebral artery along with autologous muscle graft interposition technique is appropriate in microvascular decompression surgery to relieve vertebral artery compression of medulla oblongata.

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Lightsey, Harry M., Grace X. Xiong, Andrew J. Schoenfeld, and Andrew K. Simpson. "Microendoscopic decompression of conjoined lumbosacral nerve roots." BMJ Case Reports 15, no. 3 (March 2022): e248680. http://dx.doi.org/10.1136/bcr-2021-248680.

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Nerve root morphological variability is often incompletely appreciated on preoperative imaging and can complicate intraoperative decision-making. This case demonstrates the utility of spinal endoscopy in the visualisation and manipulation of conjoined nerve roots and includes procedural images to promote better understanding and awareness of this anatomical anomaly. A woman in her 50s presented with 1 year of progressive left S1 radiculopathy refractory to non-operative modalities. History and examination were notable for S1 dermatomal paresthesias, positive ipsilateral straight leg raise and grade 4/5 gastrocnemius strength. MRI demonstrated an L5–S1 left paracentral disc herniation causing severe lateral recess stenosis. Endoscopic decompression revealed conjoined lumbosacral nerve roots. Laminotomies and discectomy provided circumferential decompression. The patient experienced immediate and sustained relief of her preoperative radiculopathy as manifested in patient-reported outcome measures. Evolving endoscopic spine platforms provide novel visualisation of nerve root anomalies yielding new insight on safe and effective decompressive techniques.

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Akar, Ezgi, Ahmet Öğrenci, Orkun Koban, Mesut Yılmaz, and Sedat Dalbayrak. "Comparing Ipsilateral and Contralateral Laminotomy with Bilateral Decompression in Cases with Far Lateral Disk Herniation and Lumbar Spinal Stenosis." Indian Journal of Neurosurgery 10, no. 02 (July 15, 2021): 121–27. http://dx.doi.org/10.1055/s-0041-1726604.

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Abstract Introduction The aim of this study was to compare clinical results of bilateral decompression and laminotomy and contralateral laminotomy following discectomy from the same side in patients who have far lateral disk herniation and lumbar spinal stenosis at the same level. Materials and Methods Twenty-four patients with far lateral disk herniation have been divided into two groups: group 1 (n = 14), those who have been through bilateral canal decompression with far lateral discectomy and ipsilateral approach, and group 2 (n = 10), those who have been through far lateral discectomy and bilateral decompression with unilateral approach from contralateral side. Early postoperative, 1st month, and 12th month back and leg pain Visual Analogue Scale (VAS) scores of the patients have been retrospectively evaluated. Results There is no significant difference between 1st month back and leg pain VAS scores of the groups. But 12th month back and leg pain VAS scores of group 1 are significantly higher than 1st month VAS scores. Also, 12th month back and leg pain VAS scores of group 1 are significantly higher than group 1. In the scanning carried out when the complaints of eight patients in group 1 continued, pars interarticularis fracture has been observed on the side where the surgery has been performed (57.1%). Six of these eight patients have been through stabilization surgery (42.8%). Conclusion Long-term postoperative results are better in cases who have been performed bilateral decompression with unilateral approach from contralateral side with median incision following paramedian incision discectomy in patients with far lateral disk herniation and spinal stenosis.

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Wu, Pang Hung, Hyeun Sung Kim, and Il-Tae Jang. "How I do it? Uniportal full endoscopic contralateral approach for lumbar foraminal stenosis with double crush syndrome." Acta Neurochirurgica 162, no. 2 (December 10, 2019): 305–10. http://dx.doi.org/10.1007/s00701-019-04157-z.

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Abstract Background Evolution of endoscopic surgery provides equivalent results to open surgery with advantages of minimal invasive surgery. The literature on technique Uniportal Full endoscopic contralateral approach is scarce. Methods The endoscopic contralateral approach technique applies for patients presenting with double crush syndrome with foraminal and extraforminal stenosis. The key steps focus on contralateral ventral overriding superior articular process decompression, foraminal and extraforaminal discectomy, and lateral vertebral syndesmophyte decompression leading to enlargement of the contralateral foramen and extraforamen size. Conclusion The Uniportal Full endoscopic contralateral approach is a good alternative to open surgery or minimally invasive microscopic surgery through direct endoscopic visualization of the entire route of exiting nerve with no neural retraction allowing both lateral recess and foraminal and extraforaminal decompression all in one approach.

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Heo, Dong Hwa, and Jin-Sung Kim. "Clinical and radiological outcomes of spinal endoscopic discectomy–assisted oblique lumbar interbody fusion: preliminary results." Neurosurgical Focus 43, no. 2 (August 2017): E13. http://dx.doi.org/10.3171/2017.5.focus17196.

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OBJECTIVEDirect neural decompression cannot be achieved by performing lateral lumbar interbody fusion (LLIF). To overcome the indirect decompressive effect of LLIF, additional endoscopic discectomy with oblique lumbar interbody fusion (OLIF) has been attempted. The purpose of this study was to assess the clinical and radiological outcomes of patients who underwent OLIF with additional endoscopic discectomy.METHODSSpinal endoscopic discectomy–assisted OLIF was attempted to remove herniated disc material. Only patients with a follow-up time that exceeded 12 months were enrolled. Clinical parameters examined were the Oswestry Disability Index and visual analog scale scores of back and leg pain. Postoperative MRI was also performed.RESULTSFourteen patients were enrolled. Central and foraminal disc herniations were evident in 8 and 6 patients, respectively. Concomitant central or foraminal herniated discs were removed completely after additional endoscopic discectomy, and disc removal was confirmed by postoperative MRI. Mean preoperative visual analog scale scores and Oswestry Disability Index scores improved postoperatively.CONCLUSIONSOLIF with additional endoscopic discectomy results in successful direct neural decompression without posterior decompressive procedures. Endoscopic assistance might overcome the limitations of LLIF.

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Matsumoto, Koji, Anoli Shah, Amey Kelkar, Dikshya Parajuli, Sushil Sudershan, Vijay K. Goel, and Koichi Sairyo. "Biomechanical evaluation of a novel decompression surgery: Transforaminal full-endoscopic lateral recess decompression (TE-LRD)." North American Spine Society Journal (NASSJ) 5 (March 2021): 100045. http://dx.doi.org/10.1016/j.xnsj.2020.100045.

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White, W. Abraham, William L. White, and Peter E. Shapiro. "Combined endoscopic medial and inferior orbital decompression with transcutaneous lateral orbital decompression in Graves' orbitopathy." Ophthalmology 110, no. 9 (September 2003): 1827–32. http://dx.doi.org/10.1016/s0161-6420(03)00566-9.

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Ünal, Mehmet, Fikret Ileri, Onur Konuk, and Berati Hasanreisogglu. "Balanced orbital decompression in Graves' orbitopathy: Upper eyelid crease incision for extended lateral wall decompression." Orbit 19, no. 2 (January 2000): 109–17. http://dx.doi.org/10.1076/0167-6830(200006)1921-pft109.

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�nal, Mehmet, Fikret Ileri, Onur Konuk, and Berati Hasanreisogglu. "Balanced orbital decompression in Graves' orbitopathy: Upper eyelid crease incision for extended lateral wall decompression." Orbit 19, no. 2 (June 1, 2000): 109–17. http://dx.doi.org/10.1076/0167-6830(200006)19:2;1-p;ft109.

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Kakizaki, Hirohiko. "Advantageous Surgeon’s Position in Deep Lateral Orbital Wall Decompression." Orbit 30, no. 3 (May 16, 2011): 131. http://dx.doi.org/10.3109/01676830.2011.558976.

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Almousa, Radwan, and Gangadhara Sundar. "Acquired epiblepharon treated by lateral orbital and fat decompression." Middle East African Journal of Ophthalmology 18, no. 1 (2011): 80. http://dx.doi.org/10.4103/0974-9233.75897.

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Haklar, Ugur, Egemen Ayhan, Sinan Ustundag, and Kerem Canbora. "A new arthroscopic technique for lateral parameniscal cyst decompression." Knee 21, no. 1 (January 2014): 126–28. http://dx.doi.org/10.1016/j.knee.2013.04.019.

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Xu, Jie, WeiDa Zhuang, Wu Zheng, Yuhua Xiao, and Yuan Lin. "Microscopic Ventral Neural Decompression in Oblique Lateral Interbody Fusion." World Neurosurgery 128 (August 2019): e315-e321. http://dx.doi.org/10.1016/j.wneu.2019.04.142.

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Larsen, Dorte Ancher, Niels Ehlers, and Toke Bek. "Thyroid-associated orbitopathy (TAO) treated by lateral orbital decompression." Acta Ophthalmologica Scandinavica 82, no. 1 (February 2004): 108–9. http://dx.doi.org/10.1111/j.1395-3907.2004.0189d.x.

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Ramesh, Sathyadeepak, Knut Eichhorn, Steven Leibowitz, and Robert Goldberg. "Reply Re: “Bony Regrowth After Deep Lateral Orbital Decompression”." Ophthalmic Plastic and Reconstructive Surgery 35, no. 2 (2019): 205–6. http://dx.doi.org/10.1097/iop.0000000000001326.

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