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In Sweden, the national registry of lumbar spine surgery reported in the year 2000 that 15% of patients with spinal stenosis surgery underwent a concomitant fusion. [218] Despite the traditionally conservative approach to spinal surgery in Sweden, there have been calls for a more aggressive approach to lumbar procedures in recent years.
Failed back syndrome is a significant, potentially disabling, result that can arise following invasive spine surgery to treat disc herniation. Smaller spine procedures such as endoscopic transforaminal lumbar discectomy cannot cause failed back syndrome, because no bone is removed. [64]
Lumbar spinal stenosis (LSS) is a medical condition in which the spinal canal narrows and compresses the nerves and blood vessels at the level of the lumbar vertebrae. Spinal stenosis may also affect the cervical or thoracic region, in which case it is known as cervical spinal stenosis or thoracic spinal stenosis.
Common symptoms of lumbar stenosis are pain, fatigue, weakness of the muscle and numbness. [2] Stenosis can be caused by old age or an injury to the vertebral column and usually requires a CT scan or MRI to diagnose. [2] Performing a laminotomy can relieve pressure in the spinal canal caused by lumbar stenosis and therefore alleviate symptoms. [1]
Symptoms of LSS, including NC, are the most common reason patients 65 and older undergo spinal surgery. Surgery is generally reserved for patients whose symptoms do not improve with nonsurgical treatments, and the main objective of surgery is to relieve pressure on the spinal nerve roots and recover normal mobility and quality of life. [10]
Such severe spinal stenosis symptoms are virtually absent in lumbar stenosis, however, as the spinal cord terminates at the top end of the adult lumbar spine, with only nerve roots (cauda equina) continuing further down. [15] Cervical spinal stenosis is a condition involving narrowing of the spinal canal at the level of the neck.
Facet syndrome is a syndrome in which the facet joints (synovial diarthroses) cause painful symptoms. [1] In conjunction with degenerative disc disease, a distinct but functionally related condition, facet arthropathy is believed to be one of the most common causes of lower back pain. [2] [3]
A spinal CSF leak can be caused by one or more meningeal diverticula or CSF-venous fistulas not associated with an epidural leak. [6] [7] [8] A spontaneous spinal cerebrospinal fluid leak may occur sometimes in those with predisposing heritable connective tissue disorders including Marfan syndrome and Ehlers–Danlos syndromes.