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  1. NTU Scholars
  2. 工學院
  3. 醫學工程學研究所
Please use this identifier to cite or link to this item: https://scholars.lib.ntu.edu.tw/handle/123456789/464261
Title: Clinical significance of postdecompression facet joint effusion after minimally invasive decompression for degenerative lumbar spinal stenosis
Authors: Pao, J.-L.
Chen, W.-C.
Chang, C.-H.
Chen, C.-S.
Wang, J.-L.
JAW-LIN WANG 
Keywords: Complication; Degenerative lumbar spinal stenosis; Facet joint effusion; Incidence; Magnetic resonance imaging; Microendoscopic decompression; Minimally invasive spine surgery; Postdecompression facet effusion; Segmental instability; Treatment outcomes
Issue Date: 2014
Journal Volume: 27
Journal Issue: 8
Source: Journal of Spinal Disorders and Techniques
Abstract: 
Study Design: A retrospective case series study.Objective: To investigate the clinical significance of postdecompression facet effusion (PDFE) after microendoscopic decompressive laminotomy (MEDL).Summary of Background Data: The facet joint effusion noted on magnetic resonance imaging was considered as an indicator of degeneration of the facet joints and segmental instability. PDFE occurring after MEDL might imply postdecompression segmental instability. Its clinical significance has not yet been clarified.Materials and Methods: From 2005 to 2010, 165 patients with degenerative lumbar spinal stenosis (average age: 64.5, average follow-up: 25.8mo) who received MEDL were reviewed. We investigated the incidence of PDFE with preoperative and repetitive magnetic resonance imaging at 6 months postoperatively. The clinical data and treatment courses were reviewed. The treatment outcomes were evaluated with Oswestry Disability Index and Japanese Orthopedic Association scores.Results: The incidence of PDFE was 17.0% (n =28), which was significantly higher in patients receiving multilevel decompression and patients with scoliosis or spondylolisthesis. The intensity of low back pain was similar between patients with and without PDFE, but "mechanical" low back pain was only noted in patients with PDFE. Of the 28 patients with PDFE, only 9 symptomatic patients required invasive treatment (5 facet joint steroid injection, 3 revision MEDL, and 1 spinal fusion). Although the postoperative Oswestry Disability Index and Japanese Orthopedic Association scores were significantly worse these 9 patients, the final outcomes were good. Progression of spondylolisthesis was noted in 2 patients without PDFE but no patients with PDFE during the follow-up period.Conclusions: The relatively high incidence of PDFE after MEDL suggests that injury to the integrity of facet joint is inevitable during decompression of the stenosis, even using minimally invasive techniques. However, the overall stability is well preserved with very rare progression of spondylolisthesis. Most patients with PDFE are asymptomatic. The prognosis of PDFE is very good. Spinal fusion is rarely indicated. Copyright ? 2014 by Lippincott Williams & Wilkins.
URI: https://scholars.lib.ntu.edu.tw/handle/123456789/464261
DOI: 10.1097/BSD.0000000000000126
SDG/Keyword: steroid; adult; aged; Article; asymptomatic disease; case study; cyst; degenerative lumbar spinal stenosis; disease course; female; follow up; functional status; human; intraspinal facet cyst; Japanese Orthopaedic Association score; low back pain; lumbar spinal stenosis; major clinical study; male; medical record review; microendoscopic decompressive laminotomy; minimally invasive surgery; nuclear magnetic resonance imaging; Oswestry Disability Index; postdecompression facet effusion; postdecompression facet effusion; postoperative complication; postoperative period; preoperative evaluation; prognosis; scoliosis; spine fusion; spine instability; spondylolisthesis; treatment outcome; adverse effects; back; complication; decompression surgery; disability; endoscopy; Intervertebral Disc Degeneration; low back pain; microsurgery; middle aged; minimally invasive surgery; pathology; Postoperative Complications; retrospective study; Spinal Stenosis; zygapophyseal joint; Aged; Decompression, Surgical; Disability Evaluation; Endoscopy; Female; Humans; Intervertebral Disc Degeneration; Low Back Pain; Lumbosacral Region; Magnetic Resonance Imaging; Male; Microsurgery; Middle Aged; Minimally Invasive Surgical Procedures; Postoperative Complications; Retrospective Studies; Spinal Stenosis; Treatment Outcome; Zygapophyseal Joint
[SDGs]SDG3
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臺大位居世界頂尖大學之列,為永久珍藏及向國際展現本校豐碩的研究成果及學術能量,圖書館整合機構典藏(NTUR)與學術庫(AH)不同功能平台,成為臺大學術典藏NTU scholars。期能整合研究能量、促進交流合作、保存學術產出、推廣研究成果。

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