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

  • Original Article - Spine
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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.

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, Stavanger University Hospital, NO, 4068, Stavanger, Norway

    Clemens Weber

  2. Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway

    Greger Lønne, Ole Solheim, Ivar Rossvoll, Øystein P. Nygaard & Sasha Gulati

  3. Department of Orthopedic Surgery, Innlandet Hospital Trust, Lillehammer, Norway

    Greger Lønne

  4. Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway

    Vidar Rao, Ole Solheim, Ulf Nerland, Øystein P. Nygaard & Sasha Gulati

  5. Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden

    Asgeir S. Jakola

  6. Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Asgeir S. Jakola

  7. National Advisory Unit on Spinal Surgery, St. Olavs Hospital, Trondheim, Norway

    Ivar Rossvoll & Øystein P. Nygaard

  8. Department of Orthopedic Surgery, St. Olavs University Hospital, Trondheim, Norway

    Ivar Rossvoll

  9. Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands

    Wilco C. Peul

Authors
  1. Clemens Weber
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  2. Greger Lønne
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  3. Vidar Rao
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  4. Asgeir S. Jakola
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  5. Ole Solheim
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  6. Ulf Nerland
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  7. Ivar Rossvoll
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  8. Øystein P. Nygaard
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  9. Wilco C. Peul
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  10. Sasha Gulati
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Corresponding author

Correspondence to Clemens Weber.

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Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. This article does not contain any studies with human participants performed by any of the authors.

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No funding was received for this research.

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Weber, C., Lønne, G., Rao, V. et al. Surgical management of lumbar spinal stenosis: a survey among Norwegian spine surgeons. Acta Neurochir 159, 191–197 (2017). https://doi.org/10.1007/s00701-016-3020-0

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  • DOI: https://doi.org/10.1007/s00701-016-3020-0

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