Clemens Weber1, Greger Lønne2,3, Vidar Rao4, Asgeir S Jakola5,6, Ole Solheim2,4, Ulf Nerland4, Ivar Rossvoll2,7,8, Øystein P Nygaard2,4,7, Wilco C Peul9, Sasha Gulati2,4. 1. Department of Neurosurgery, Stavanger University Hospital, NO, 4068, Stavanger, Norway. clemens.weber@gmail.com. 2. Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway. 3. Department of Orthopedic Surgery, Innlandet Hospital Trust, Lillehammer, Norway. 4. Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway. 5. Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden. 6. Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 7. National Advisory Unit on Spinal Surgery, St. Olavs Hospital, Trondheim, Norway. 8. Department of Orthopedic Surgery, St. Olavs University Hospital, Trondheim, Norway. 9. Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands.
Abstract
BACKGROUND: Symptomatic lumbar spinal stenosis (LSS) is the most common reason for lumbar surgery in the elderly. There is growing evidence that decompressive surgery offers an advantage over non-surgical management for selected patients with persistent severe symptoms. Based on treatment traditions, open laminectomy has been the gold standard surgical treatment, but various other surgical and non-surgical treatments for LSS are widely used in clinical practice. Therefore, we conducted a survey study to capture potential diversities in surgeons' management of LSS in Norway. METHODS: All spine surgeons in Norway were contacted by e-mail and asked to answer a 20-item questionnaire by using an Internet-based survey tool. We asked eight questions about the respondent (gender, surgical specialty, workplace, experience, number of surgeries performed per year, use of magnification devices) and 12 questions about different aspects of the surgical treatment of LSS (indication for surgery and preoperative imaging, different surgical techniques, clinical outcome). RESULTS: The questionnaire was answered by 51 spine surgeons (47% response rate). The preferred surgical technique for LSS in Norway is microdecompression via a unilateral approach and crossover technique, followed by microdecompression via a bilateral approach. Other techniques are not much used in Norway. CONCLUSIONS: Most Norwegian spine surgeons use minimally invasive decompression techniques in the surgical treatment of LSS, and unilateral microsurgical decompression with crossover decompression is the preferred technique. Where evidence is lacking (e.g., fusion procedures), there is a larger variation of opinions and preferred procedures among Norwegian spine surgeons.
BACKGROUND: Symptomatic lumbar spinal stenosis (LSS) is the most common reason for lumbar surgery in the elderly. There is growing evidence that decompressive surgery offers an advantage over non-surgical management for selected patients with persistent severe symptoms. Based on treatment traditions, open laminectomy has been the gold standard surgical treatment, but various other surgical and non-surgical treatments for LSS are widely used in clinical practice. Therefore, we conducted a survey study to capture potential diversities in surgeons' management of LSS in Norway. METHODS: All spine surgeons in Norway were contacted by e-mail and asked to answer a 20-item questionnaire by using an Internet-based survey tool. We asked eight questions about the respondent (gender, surgical specialty, workplace, experience, number of surgeries performed per year, use of magnification devices) and 12 questions about different aspects of the surgical treatment of LSS (indication for surgery and preoperative imaging, different surgical techniques, clinical outcome). RESULTS: The questionnaire was answered by 51 spine surgeons (47% response rate). The preferred surgical technique for LSS in Norway is microdecompression via a unilateral approach and crossover technique, followed by microdecompression via a bilateral approach. Other techniques are not much used in Norway. CONCLUSIONS: Most Norwegian spine surgeons use minimally invasive decompression techniques in the surgical treatment of LSS, and unilateral microsurgical decompression with crossover decompression is the preferred technique. Where evidence is lacking (e.g., fusion procedures), there is a larger variation of opinions and preferred procedures among Norwegian spine surgeons.
Authors: David B Anderson; Manuela L Ferreira; Ian A Harris; Gavin A Davis; Ralph Stanford; David Beard; Qiang Li; Stephen Jan; Ralph J Mobbs; Christopher G Maher; Renata Yong; Tara Zammit; Jane Latimer; Rachelle Buchbinder Journal: BMJ Open Date: 2019-02-13 Impact factor: 2.692
Authors: Kai-Uwe Lewandrowski; José-Antonio Soriano-Sánchez; Xifeng Zhang; Jorge Felipe Ramírez León; Sergio Soriano Solis; José Gabriel Rugeles Ortíz; Carolina Ramírez Martínez; Gabriel Oswaldo Alonso Cuéllar; Kaixuan Liu; Qiang Fu; Marlon Sudário de Lima E Silva; Paulo Sérgio Teixeira de Carvalho; Stefan Hellinger; Álvaro Dowling; Nicholas Prada; Gun Choi; Girish Datar; Anthony Yeung Journal: J Spine Surg Date: 2020-01