Article
Clinical Neurology
Timothy Deer, Christopher Kim, Sayed Emal Wahezi, Huaguang Qu, Dawood Sayed
Summary: The combination of minimally invasive surgery (MILD) and conventional medical management showed superior outcomes at 6 months compared to conventional medical management alone. Results demonstrated better walking tolerance test outcomes and lower incidence of subsequent disallowed procedures in the MILD+CMM group.
JOURNAL OF PAIN RESEARCH
(2021)
Article
Medicine, General & Internal
Joohyun Kim, Woo-Keun Kwon, Hyunwook Cho, Subum Lee, Jang-Bo Lee, Jung-Yul Park, Dong Uk Jin, Eui Yub Jung, Junseok W. Hur
Summary: This study reveals that ligamentum flavum hypertrophy is an important factor in lumbar spinal canal stenosis and has a significant impact on clinical symptoms and outcomes compared to other components such as disc bulging and facet hypertrophy.
Review
Clinical Neurology
Hongjie Yuan, Xiaobin Yi
Summary: This narrative review aims to clarify the efficacy, safety profile, certain procedure details, advantages, and limitations of MILD for LSS. According to the literature, MILD is an effective and safe procedure that can significantly reduce pain intensity and improve functional status in LSS patients.
JOURNAL OF PAIN RESEARCH
(2023)
Article
Clinical Neurology
Michael L. Martini, Dominic A. Nistal, Brian C. Deutsch, Sean N. Neifert, Colin D. Lamb, John M. Caridi
Summary: Neurogenic claudication does not significantly increase the odds of adverse outcomes following surgical fusion for lumbar spinal stenosis. Interestingly, patients with neurogenic claudication had lower total hospitalization charges following PLIF and LLIF surgeries, but not ALIF surgeries.
GLOBAL SPINE JOURNAL
(2021)
Article
Clinical Neurology
Keith M. George, Nicholas S. Hernandez, Jeffrey Breton, Baillee Cooper, Richard S. Dowd, Jayde Nail, Anthony Yu, Michael Mastroianni, Andy Wang, Amandeep Godara, Diana Zhang, Knarik Arkun, Ayan R. Patel, Cindy Varga, Oscar Soto, James Kryzanski, Raymond Comenzo, Ron Riesenburger
Summary: This study found that the lumbar LF burden is greater in patients with ATTRwt amyloid compared to non-ATTRwt patients, supporting previous evidence of an association between ATTRwt amyloid deposition, increased LF thickness, and lumbar stenosis.
CLINICAL NEUROLOGY AND NEUROSURGERY
(2021)
Review
Orthopedics
Alan H. Daniels, Christopher L. McDonald, Bryce A. Basques, Eren O. Kuris
Summary: Ossification of the ligamentum flavum (OLF) is a spinal condition that can potentially cause compression of the spinal canal and neurological damage. The exact cause is debated but is likely related to gene overexpression and signaling pathways. Progressive myelopathy is the most common symptom, and radiographic analysis can show ossification in different areas. Surgical treatment options exist but may result in complications and postoperative neurological deficits.
JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS
(2022)
Article
Clinical Neurology
Ralf Wagner, Monika Haefner
Summary: Full-endoscopic interlaminar bilateral decompression is an effective technique for lumbar spinal stenosis, with clear advantages including shorter surgical time, minimal damage, and good clinical outcomes. However, it requires skilled surgeons to perform and may become the gold standard for treatment in the future.
WORLD NEUROSURGERY
(2021)
Article
Clinical Neurology
Yoshiyuki Takahashi, Haruki Funao, Kodai Yoshida, Yutaka Sasao, Makoto Nishiyama, Norihiro Isogai, Ken Ishii
Summary: This study assessed the sequential magnetic resonance imaging changes of indirect neural decompression after minimally invasive lumbar lateral interbody fusion combined with posterior percutaneous pedicle screw fixation for degenerative spondylolisthesis. It was found that the sequential enlargement of the spinal canal was achieved by thinning of the ligamentum flavum, even in patients with severe lumbar spinal stenosis. The effect of indirect neural decompression was equivalent, regardless of the severity of preoperative lumbar spinal stenosis.
WORLD NEUROSURGERY
(2021)
Article
Anesthesiology
Ahmed J. Awad, Braden Jex, Gwynne Kirchen, Stacy Peterson, Sarah A. Endrizzi, Peter A. Pahapill
Summary: The study demonstrates the favorable long-term efficacy of SCS in treating neurogenic claudication, especially for patients without prior surgical decompression. Despite its retrospective nature and single-center design, the results suggest that SCS can be considered as part of conservative treatment to help patients alleviate spine-related pain.
Article
Chemistry, Multidisciplinary
Atsushi Mihara, Norihiro Nishida, Fei Jiang, Junji Ohgi, Yasuaki Imajo, Hidenori Suzuki, Masahiro Funaba, Hiroki Yamagata, Xian Chen, Takashi Sakai
Summary: The mechanical properties of the ligamentum flavum change with age, with age being the only factor significantly correlated with stiffness.
APPLIED SCIENCES-BASEL
(2021)
Article
Biotechnology & Applied Microbiology
Xing Du, Yuxiao She, Yunsheng Ou, Yong Zhu, Wei Luo, Dianming Jiang
Summary: This study compared the efficacy of OLIF and TLIF in single-level degenerative lumbar spondylolisthesis surgery, showing that the OLIF group had advantages in operation time, blood loss, postoperative drainage, and hospital stay over the TLIF group, with similar bone fusion rates postoperatively. There were no significant differences in complications between the two groups in long-term follow-up.
BIOMED RESEARCH INTERNATIONAL
(2021)
Article
Multidisciplinary Sciences
Vuk Aleksic, Jovana Todorovic, Nenad Miladinovic, Nemanja Aleksic, Vojislav Bogosavljevic, Marko Durovic, Svetlana Kocic, Radmila Aleksic, Milos Jokovic
Summary: This observational cohort study examined the ligamentum flavum in patients with lumbar spinal stenosis (LSS) and lumbar disc herniation (LDH) to investigate the pathophysiology of neurogenic claudication. The thickening of ligamentum flavum in LSS patients was found to be the main cause of stenosis, and histological analysis revealed differences in the amount of collagen and elastic fibers between the groups. These findings support the inflammatory theory of spinal neurogenic claudication.
SCIENTIFIC REPORTS
(2023)
Article
Clinical Neurology
Jianwei Chen, Xiaosheng Yu, Manle Qiu, Fan Feng, Zude Liu, Guibin Zhong
Summary: This study identified differentially expressed circRNAs in hypertrophic ligamentum flavum (LFH) compared to nonhypertrophic tissues in lumbar spinal stenosis patients. Specifically, hsa_circ_0052318 was shown to play a significant role in the pathogenesis of LF hypertrophy.
Article
Anesthesiology
Timothy R. Deer, Shrif J. Costandi, Edward Washabaugh, Timothy B. Chafin, Sayed E. Wahezi, Navdeep Jassal, Dawood Sayed
Summary: The study aims to compare the effectiveness of minimally invasive lumbar decompression combined with conventional medical management versus conventional medical management alone for patients with neurogenic claudication secondary to hypertrophic ligamentum flavum, showing superiority of the former in primary and secondary outcomes. The study demonstrates that the mild procedure is a safe, durable, minimally invasive therapy for patients with symptomatic lumbar spinal stenosis.
Article
Clinical Neurology
Hasibullah Habibi, Akinobu Suzuki, Kazunori Hayashi, Hamidullah Salimi, Hidetomi Terai, Yusuke Hori, Koji Tamai, Kumi Orita, Shoichiro Ohyama, Akito Yabu, Mohammad Hasib Maruf, Hiroaki Nakamura
Summary: This study revealed the upregulation of FGF9 in hypertrophied human LF, indicating its pivotal role in the hypertrophy process through cell proliferation and migration.