Search

Your search keyword '"Burgstaller, Jakob M."' showing total 3 results
Start Over Author "Burgstaller, Jakob M." Journal bmc musculoskeletal disorders
3 results on '"Burgstaller, Jakob M."'

2. The impact of incidental durotomy on the outcome of decompression surgery in degenerative lumbar spinal canal stenosis: analysis of the Lumbar Spinal Outcome Study (LSOS) data--a Swiss prospective multi-center cohort study.

Author

Ulrich, Nils H., Burgstaller, Jakob M., Brunner, Florian, Porchet, François, Farshad, Mazda, Pichierri, Giuseppe, Steurer, Johann, Held, Ulrike, and LSOS Study Group

Subjects
*SURGICAL decompression, *SPINAL stenosis treatment, *PATIENT management, *SURGERY safety measures, *LUMBAR vertebrae surgery, *COMPARATIVE studies, *DIAGNOSIS, *LONGITUDINAL method, *RESEARCH methodology, *MEDICAL cooperation, *QUESTIONNAIRES, *RESEARCH, *SPINAL stenosis, *SURGICAL complications, *EVALUATION research, *TREATMENT effectiveness, HEALTH management
Abstract

Background: Incidental durotomy is a well-known complication during surgery for degenerative lumbar spinal stenosis (DLSS). In this prospective multicenter cohort study including eight medical centers our aim was to assess whether incidental durotomy during first-time lumbar spinal stenosis decompression surgery without fusion has an impact on long-term outcome.Methods: Patients of the multi-center Lumbar Stenosis Outcome Study (LSOS) with confirmed DLSS undergoing first-time decompression without fusion were enrolled in this study. Baseline patient characteristics and outcomes were analyzed at 6, 12, and 24 months follow-up respectively with the Spinal Stenosis Measure (SSM), the Numeric Rating Scale (NRS), Feeling Thermometer (FT), the EQ-5D-EL, and the Roland and Morris Disability Questionnaire (RMDQ).Results: A total of 167 patients met the inclusion criteria. Fifteen (9%) of those patients had an incidental durotomy. Baseline characteristics were similar between the durotomy and no-durotomy group. All patients improved over time. In the group of durotomy patients, the median improvement in SSM symptoms scale was 1.1 points at 6 months, 1.1 points at 12 months, and 1.6 points at 24 months after baseline. For the no-durotomy group, these improvements were 0.8, 0.9, and 0.9. For SSM function the improvements were 1.0, 0.8, and 0.9 in the durotomy group, and 0.6, 0.8, and 0.8 in the no-durotomy group. None of the between-group differences were statistically significant.Conclusions: Incidental durotomy in patients with DLSS undergoing first-time decompression surgery without fusion did not have negative effect on long-term outcome and quality of life. However, only 15 patients were included in the durotomy group but these findings remained even after adjusting for observed differences in baseline characteristics. [ABSTRACT FROM AUTHOR]

Published
2016
Full Text
View/download PDF

3. Arguments for the choice of surgical treatments in patients with lumbar spinal stenosis – a systematic appraisal of randomized controlled trials

Author

Johann Steurer, Maria M. Wertli, Jakob M Burgstaller, François Porchet, University of Zurich, and Burgstaller, Jakob M

Subjects
Decompression, Reoperation, musculoskeletal diseases, medicine.medical_specialty, Fecompression and fusion with instrumentation, Spinal stenosis, 2745 Rheumatology, 610 Medicine & health, Cochrane Library, Prosthesis Design, Risk Assessment, law.invention, 2732 Orthopedics and Sports Medicine, Spinal Stenosis, Rheumatology, Randomized controlled trial, Risk Factors, law, medicine, Humans, Low back pain, Orthopedics and Sports Medicine, Randomized Controlled Trials as Topic, Pain, Postoperative, Lumbar Vertebrae, business.industry, Patient Selection, Instability, Lumbar spinal stenosis, Decompression, Surgical, medicine.disease, humanities, Surgery, Spinal Fusion, Treatment Outcome, Systematic review, Orthopedic surgery, 10029 Clinic and Policlinic for Internal Medicine, medicine.symptom, business, Decompression and fusion, Research Article
Abstract

Background Lumbar spinal stenosis is the most common reason for spinal surgery in elderly patients. However, the surgical management of spinal stenosis is controversial. The aim of this review was to list aspects a surgeon considers when choosing a specific type of treatment. Methods Appraisal of arguments reported in randomized controlled trials (RCTs) included in systematic reviews published or indexed in the Cochrane library studying surgical treatments in patients with spinal stenosis. Results Eight out of nine RCTs listed arguments for the choice of their treatments under investigation. The argument for decompression alone was the high success rate, the argument against was a potential increase in vertebral instability. The argument for decompression and fusion without instrumentation was that it is a well-established technique with a high fusion success rate, the argument against it was that the indication for fusion in spinal stenosis has remained unclear. The argument for decompression and fusion with instrumentation was an increased fusion rate compared to decompression and fusion without instrumentation, the argument against this was that the invasive procedure is associated with more complications. Conclusions The main argument identified in this appraisal for and against decompression alone in patient with lumbar spinal stenosis was whether or not instability should be treated with (instrumented) fusion procedures. However, there is disagreement on how instability should be defined. In a first step it is important that researchers and clinicians agree on definitions for important key concepts such as instability and reoperations. Electronic supplementary material The online version of this article (doi:10.1186/s12891-015-0548-8) contains supplementary material, which is available to authorized users.

Published
2015
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results