Spinal Shortening Surgery for Lumbosacral Nerve Bowstring Disease: A Surgical Technique

Summary

Lumbosacral nerve bowstring disease (LNBD) is a syndrome comprising a series of neurological symptoms caused by high axial tension of the lumbosacral nerve due to congenital, iatrogenic, and other factors. Here, we introduce a surgical technique for the treatment of LNBD through spinal shortening surgery.

Abstract

Lumbosacral nerve bowstring disease (LNBD) is a syndrome of neurological symptoms caused by differences in the development speed of lumbosacral bone tissue and nerve tissue, which result in a longitudinal stretch of the slow-growing nerve tissue. LNBD is usually caused by congenital factors and accompanied by other lumbosacral diseases, such as lumbar spinal stenosis, lumbar spondylolisthesis, and iatrogenic factors. The main symptoms of LNBD are lower extremity neurological symptoms and fecal dysfunction. The conservative treatment of LNBD includes rest, functional exercise, and drug therapy, but it usually fails to achieve satisfactory clinical results. Few studies have reported on the surgical treatment of LNBD. In this study, we used posterior lumbar interbody fusion (PLIF) to shorten the spine (0.6-0.8mm/segment). This reduced the axial tension of the lumbosacral nerves and relieved the patient's neurological symptoms. We report on the case of a 45 year old male patient whose main symptoms were left lower extremity pain, decreased muscle strength, and hypoesthesia. The above symptoms were significantly relieved 6 months after surgery.

Introduction

Lumbosacral nerve bowstring disease (LNBD) comprises a series of symptoms associated with nerve damage. LNBD is caused by increased lumbosacral nerve tension due to congenital developmental factors, iatrogenic injury, and a variety of other reasons¹. LNBD can also be accompanied by other lumbosacral diseases, such as lumbar disc herniation, spinal stenosis, lumbar spondylolisthesis, and scoliosis². Previous studies have found that the lengthening of the nerve roots is accompanied by a decrease in their cross-sectional areas^3,4. Electrophysiological monitoring has....

Protocol

The protocol was approved by the Ethics Committee of the Third Hospital of Hebei Medical University. Informed consent was obtained from the patient before inclusion in the study.

1. Inclusion and exclusion criteria

1. Select patients according to the following inclusion criteria and exclusion criteria.
   1. Inclusion criteria: 1) LNBD patients with severe neurological symptoms; 2) patients with complete clinical data, including basic data, treatment records, an.......

Discussion

LNBD comprises a series of neurological symptoms caused by congenital or iatrogenic factors that lead to the traction of the lumbosacral nerve and excessive axial tension¹. The clinical symptoms of LNBD are lower extremity neurological symptoms, which mainly manifest as pain, numbness, and weakness of the lower extremities. Severe patients may have perineal numbness and fecal dysfunction. The imaging of LNBD generally shows no extraneural tissue localization or compression. Nerve root sedimentatio.......

Materials

Name	Company	Catalog Number	Comments
Bipolar electrocoagulation tweezers	Juan'en Medical Devices Co.Ltd	BZN-Q-B-S	1.2*190 mm
Compressor	Qingniu	qjz887	straight head, head width 9
Compressor	Qingniu	qjz890	forward bending 5 °, head width 9
Curette	Qingniu	20739.01	300*Ø9*5°
Disc shaver	Qingniu	qjz860	small
Disc shaver	Qingniu	qjz861	middle
Disc shaver	Qingniu	qjz862	large
Double jointed forceps	SHINVA	286920	240*8 mm
High frequency active electrodes	ZhongBangTianCheng	GD-BZ	GD-BZ-J1
Laminectomy rongeur	Qingniu	2054.03	220*3.0*130°
Laminectomy rongeur	Qingniu	2058.03	220*5.0*130°
Pedicle probe	Qingniu	qjz866	straight type, 2.0
Pedicle screw	WEGO	800386545	6.5*45 mm
Pedicle screw	WEGO	800386550	6.5*50 mm
Pituitary rongeur	Qingniu	2028.01	220x3.0 mm
Pituitary rongeur	Qingniu	2028.02	220x3.0 mm
Retractor	Qingniu	qjz901	large, double head
Retractor	Qingniu	qjz902	small, double head
Rod	WEGO	800386040	5.5*500 mm
Surgical drainage catheter set	BAINUS MEDICAL	SY-Fr16-C	100-400 ml
Titanium cage	WEGO	9051228	19*80 mm