PMID- 24906245
OWN - NLM
STAT- MEDLINE
DCOM- 20151103
LR  - 20181202
IS  - 1872-7727 (Electronic)
IS  - 0720-048X (Linking)
VI  - 84
IP  - 5
DP  - 2015 May
TI  - Minimally-invasive posterior lumbar stabilization for degenerative low back pain 
      and sciatica. A review.
PG  - 789-98
LID - S0720-048X(14)00212-5 [pii]
LID - 10.1016/j.ejrad.2014.04.012 [doi]
AB  - The most diffused surgical techniques for stabilization of the painful 
      degenerated and instable lumbar spine, represented by transpedicular screws and 
      rods instrumentation with or without interbody cages or disk replacements, 
      require widely open and/or difficult and poorly anatomical accesses. However, 
      such surgical techniques and approaches, although still considered "standard of 
      care", are burdened by high costs, long recovery times and several potential 
      complications. Hence the effort to open new minimally-invasive surgical 
      approaches to eliminate painful abnormal motion. The surgical and radiological 
      communities are exploring, since more than a decade, alternative, 
      minimally-invasive or even percutaneous techniques to fuse and lock an instable 
      lumbar segment. Another promising line of research is represented by the 
      so-called dynamic stabilization (non-fusion or motion preservation back surgery), 
      which aims to provide stabilization to the lumbar spinal units (SUs), while 
      maintaining their mobility and function. Risk of potential complications of 
      traditional fusion methods (infection, CSF leaks, harvest site pain, 
      instrumentation failure) are reduced, particularly transitional disease (i.e., 
      the biomechanical stresses imposed on the adjacent segments, resulting in delayed 
      degenerative changes in adjacent facet joints and discs). Dynamic stabilization 
      modifies the distribution of loads within the SU, moving them away from sensitive 
      (painful) areas of the SU. Basic biomechanics of the SU will be discussed, to 
      clarify the mode of action of the different posterior stabilization devices. Most 
      devices are minimally invasive or percutaneous, thus accessible to radiologists' 
      interventional practice. Devices will be described, together with indications for 
      patient selection, surgical approaches and possible complications.
CI  - Copyright (c) 2014 Elsevier Ireland Ltd. All rights reserved.
FAU - Bonaldi, G
AU  - Bonaldi G
AD  - Neuroradiology Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy. 
      Electronic address: bbonaldi@yahoo.com.
FAU - Brembilla, C
AU  - Brembilla C
AD  - Department of neurosurgery, Ospedale Papa Giovanni XXIII, Bergamo, Italy.
FAU - Cianfoni, A
AU  - Cianfoni A
AD  - Neuroradiology of Neurocenter of Italian Switzerland, Lugano, CH, Switzerland.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20140509
PL  - Ireland
TA  - Eur J Radiol
JT  - European journal of radiology
JID - 8106411
SB  - IM
MH  - Humans
MH  - Joint Instability/surgery
MH  - Low Back Pain/*surgery
MH  - Lumbar Vertebrae/*surgery
MH  - Minimally Invasive Surgical Procedures
MH  - Patient Selection
MH  - Sciatica/*surgery
MH  - Spinal Fusion/*methods
MH  - Treatment Outcome
MH  - Zygapophyseal Joint
OTO - NOTNLM
OT  - Degenerative disk disease
OT  - Dynamic fixation
OT  - Interspinous spacer
OT  - Low back pain
OT  - Lumbar fusion
OT  - Lumbar interspinous devices
OT  - Minimally invasive surgery
OT  - Spinal surgery
EDAT- 2014/06/08 06:00
MHDA- 2015/11/04 06:00
CRDT- 2014/06/08 06:00
PHST- 2014/02/09 00:00 [received]
PHST- 2014/03/26 00:00 [revised]
PHST- 2014/04/18 00:00 [accepted]
PHST- 2014/06/08 06:00 [entrez]
PHST- 2014/06/08 06:00 [pubmed]
PHST- 2015/11/04 06:00 [medline]
AID - S0720-048X(14)00212-5 [pii]
AID - 10.1016/j.ejrad.2014.04.012 [doi]
PST - ppublish
SO  - Eur J Radiol. 2015 May;84(5):789-98. doi: 10.1016/j.ejrad.2014.04.012. Epub 2014 
      May 9.