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Surgical management of lumbar spinal stenosis: a survey among Norwegian spine surgeons.

Journal article
Authors Clemens Weber
Greger Lønne
Vidar Rao
Asgeir Store Jakola
Ole Solheim
Ulf Nerland
Ivar Rossvoll
Øystein P Nygaard
Wilco C Peul
Sasha Gulati
Published in Acta neurochirurgica
Volume 159
Issue 1
Pages 191-7
ISSN 0942-0940
Publication year 2017
Published at Institute of Neuroscience and Physiology
Pages 191-7
Language en
Links dx.doi.org/10.1007/s00701-016-3020-...
www.ncbi.nlm.nih.gov/entrez/query.f...
Subject categories Neurosurgery, Orthopaedics

Abstract

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.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).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.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.

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