{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T13:30:00Z","timestamp":1780579800240,"version":"3.54.1"},"reference-count":41,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg A Cent Eur Neurosurg"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003The ideal surgical treatment of lumbar canal stenosis remains controversial. Although decompressive open surgery has been widely used with good clinical outcome, minimally invasive indirect decompression techniques have been developed to avoid the complications associated with open approaches. The purpose of this study was to evaluate the radiologic outcome and safety of the indirect decompression achieved with stand-alone percutaneous pedicle screw fixation in the surgical treatment of lumbar degenerative pathologies.<\/jats:p><jats:p>\n          Methods\u2003Twenty-eight patients presenting with spinal degenerative diseases including concomitant central and\/or lateral stenosis were treated with stand-alone percutaneous pedicle screw fixation. Radiographic measurements were made on axial and sagittal magnetic resonance (MR) images, performed before surgery and after a mean follow-up period of 25.2 months. Measurements included spinal canal and foraminal areas, and anteroposterior canal diameter.<\/jats:p><jats:p>\n          Results\u2003Percutaneous screw fixation was performed in 35 spinal levels. Measurements on the follow-up MR images showed statistically significant increase in the cross-sectional area of the spinal canal and the neural foramen, from a mean of 88.22 and 61.05\u2009mm2 preoperatively to 141.52 and 92.18\u2009mm2 at final follow-up, respectively. The sagittal central canal diameter increased from a mean of 4.9 to 9.1\u2009mm at final follow-up. Visual analog scale (VAS) pain score and Oswestry Disability Index (ODI) both improved significantly after surgery (p\u2009&lt;\u20090.0001).<\/jats:p><jats:p>\n          Conclusion\u2003Stand-alone percutaneous pedicle screw fixation is a safe and effective technique for indirect decompression of the spinal canal and neural foramina in lumbar degenerative diseases. This minimally invasive technique may provide the necessary decompression in cases of common degenerative lumbar disorders with ligamentous stenosis.<\/jats:p>","DOI":"10.1055\/s-0043-1777751","type":"journal-article","created":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T23:43:21Z","timestamp":1703029401000},"page":"038-047","source":"Crossref","is-referenced-by-count":1,"title":["Stand-Alone Percutaneous Pedicle Screw Lumbar Fixation to Indirectly Decompress the Neural Elements in Spinal Stenosis: A Radiographic Assessment Case Series"],"prefix":"10.1055","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1356-1846","authenticated-orcid":false,"given":"Roberto","family":"Gazzeri","sequence":"additional","affiliation":[{"name":"Department of Neurosurgeon - Pain Therapy, San Giovanni-Addolorata Hospital, Roma, Lazio, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Panagiotopoulos","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, San Giovanni-Addolorata Hospital, Roma, Lazio, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo","family":"Galarza","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Virgen de la Arrixaca University Hospital, El Palmar, Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo Luigi Giuseppe","family":"Leoni","sequence":"additional","affiliation":[{"name":"Unit of Interventional and Surgical Pain Management, Guglielmo da Saliceto Hospital, Piacenza, Emilia-Romagna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Agrillo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, San Giovanni-Addolorata Hospital, Roma, Lazio, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,12,19]]},"reference":[{"issue":"13","key":"ref1","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1001\/jama.2010.338","article-title":"Trends, major medical complications, and charges associated with surgery for lumbar spinal stenosis in older adults","volume":"303","author":"R A Deyo","year":"2010","journal-title":"JAMA"},{"issue":"02","key":"ref2","first-page":"103","article-title":"The current management of lumbar spondylolisthesis","volume":"57","author":"A Alfieri","year":"2013","journal-title":"J Neurosurg Sci"},{"issue":"10","key":"ref3","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1097\/00007632-199905150-00020","article-title":"Surgical management of lumbar spinal stenosis","volume":"24","author":"F Postacchini","year":"1999","journal-title":"Spine"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"S35","DOI":"10.1097\/01.brs.0000155561.70727.20","article-title":"Adult low-grade acquired spondylolytic spondylolisthesis: evaluation and management","volume":"30","author":"B K Kwon","year":"2005","journal-title":"Spine"},{"issue":"05","key":"ref5","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1007\/s00586-013-3144-3","article-title":"Surgery in lumbar degenerative spondylolisthesis: indications, outcomes and complications. A systematic review","volume":"23","author":"F Steiger","year":"2014","journal-title":"Eur Spine J"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.jocn.2018.01.008","article-title":"Evaluation and management of small dural tears in primary lumbar spinal decompression and discectomy surgery","volume":"50","author":"M Galarza","year":"2018","journal-title":"J Clin Neurosci"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"202","DOI":"10.3171\/2011.3.SPINE10716","article-title":"Incidence of postoperative symptomatic epidural hematoma in spinal decompression surgery","volume":"15","author":"H Aono","year":"2011","journal-title":"J Neurosurg Spine"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"S331","DOI":"10.1097\/BRS.0b013e3182022db0","article-title":"A radiographic assessment of the ability of the extreme lateral interbody fusion procedure to indirectly decompress the neural elements","volume":"35","author":"L Oliveira","year":"2010","journal-title":"Spine"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.jocn.2016.09.010","article-title":"Extreme lateral interbody fusion relieves symptoms of spinal stenosis and low-grade spondylolisthesis by indirect decompression in complex patients","volume":"35","author":"E A Pereira","year":"2017","journal-title":"J Clin Neurosci"},{"issue":"03","key":"ref10","doi-asserted-by":"crossref","first-page":"E175","DOI":"10.1097\/BRS.0000000000000703","article-title":"Effect of indirect neural decompression through oblique lateral interbody fusion for degenerative lumbar disease","volume":"40","author":"S Fujibayashi","year":"2015","journal-title":"Spine"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1055\/s-0031-1286334","article-title":"Evaluation of indirect decompression of the lumbar spinal canal following minimally invasive lateral transpsoas interbody fusion: radiographic and outcome analysis","volume":"54","author":"E H Elowitz","year":"2011","journal-title":"Minim Invasive Neurosurg"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"975052","DOI":"10.1155\/2014\/975052","article-title":"Controversies about interspinous process devices in the treatment of degenerative lumbar spine diseases: past, present, and future","volume":"2014","author":"R Gazzeri","year":"2014","journal-title":"BioMed Res Int"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.clineuro.2014.07.004","article-title":"Interspinous spacer decompression (X-STOP) for lumbar spinal stenosis and degenerative disk disease: a multicenter study with a minimum 3-year follow-up","volume":"124","author":"F Puzzilli","year":"2014","journal-title":"Clin Neurol Neurosurg"},{"issue":"04","key":"ref14","doi-asserted-by":"crossref","first-page":"E10","DOI":"10.3171\/foc.2001.10.4.11","article-title":"Percutaneous pedicle screw fixation of the lumbar spine","volume":"10","author":"K T Foley","year":"2001","journal-title":"Neurosurg Focus"},{"key":"ref15","first-page":"303","article-title":"Percutaneous pedicle screw fixation technique in the thoracic and lumbar spine: tips and tricks","volume":"28","author":"R Gazzeri","year":"2016","journal-title":"Surg Technol Int"},{"issue":"21","key":"ref16","doi-asserted-by":"crossref","first-page":"1919","DOI":"10.1097\/BRS.0b013e3181d359bd","article-title":"Qualitative grading of severity of lumbar spinal stenosis based on the morphology of the dural sac on magnetic resonance images","volume":"35","author":"C Schizas","year":"2010","journal-title":"Spine"},{"issue":"07","key":"ref17","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1097\/01.BRS.0000119398.22620.92","article-title":"Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective long-term study comparing fusion and pseudarthrosis","volume":"29","author":"M B Kornblum","year":"2004","journal-title":"Spine"},{"issue":"03","key":"ref18","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1097\/00002517-200006000-00002","article-title":"Spinal fusion for lumbar instability: does it have a scientific basis?","volume":"13","author":"J M Muggleton","year":"2000","journal-title":"J Spinal Disord"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"S71","DOI":"10.1097\/01.brs.0000155579.88537.8e","article-title":"Degenerative spondylolisthesis: review of current trends and controversies","volume":"30","author":"D K Sengupta","year":"2005","journal-title":"Spine"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1097\/BSD.0b013e31815b1abf","article-title":"A critical analysis of the literature regarding surgical approach and Hillebrand fusion for painful unstable isthmic spondylolisthesis in adults","volume":"21","author":"B K Kwon","year":"2008","journal-title":"J Spinal Disord Tech"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"e898","DOI":"10.1016\/j.wneu.2018.08.003","article-title":"Clinical and radiologic outcomes of direct versus indirect decompression with lumbar interbody fusion: a matched-pair comparison analysis","volume":"119","author":"G X Lin","year":"2018","journal-title":"World Neurosurg"},{"issue":"03","key":"ref22","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1007\/s00586-015-4170-0","article-title":"Radiographic evaluation of indirect decompression of mini-open anterior retroperitoneal lumbar interbody fusion: oblique lateral interbody fusion for degenerated lumbar spondylolisthesis","volume":"26","author":"J Sato","year":"2017","journal-title":"Eur Spine J"},{"issue":"06","key":"ref23","doi-asserted-by":"crossref","first-page":"623","DOI":"10.3171\/2014.1.SPINE13569","article-title":"Radiological and clinical outcomes following extreme lateral interbody fusion","volume":"20","author":"M Alimi","year":"2014","journal-title":"J Neurosurg Spine"},{"issue":"S 08","key":"ref24","first-page":"S133","article-title":"Two-year comparative outcomes of MIS lateral and MIS transforaminal interbody fusion in the treatment of degenerative spondylolisthesis: part II: radiographic findings","volume":"41","author":"R E Isaacs","year":"2016","journal-title":"Spine"},{"issue":"02","key":"ref25","doi-asserted-by":"crossref","first-page":"266","DOI":"10.21037\/jss.2019.06.03","article-title":"Quantitative analysis of indirect decompression in extreme lateral interbody fusion and posterior spinal fusion with a percutaneous pedicle screw system for lumbar spinal stenosis","volume":"5","author":"H Nomura","year":"2019","journal-title":"J Spine Surg"},{"issue":"02","key":"ref26","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1097\/01.brs.0000194780.17528.6b","article-title":"The radiographic results and neurologic complications of instrumented reduction and fusion of high-grade spondylolisthesis without decompression of the neural elements: a retrospective review of 44 patients","volume":"31","author":"F Sailhan","year":"2006","journal-title":"Spine"},{"issue":"09","key":"ref27","doi-asserted-by":"crossref","first-page":"2019","DOI":"10.1016\/j.spinee.2013.11.050","article-title":"Comparison of complications, costs, and length of stay of three different lumbar interbody fusion techniques: an analysis of the Nationwide Inpatient Sample database","volume":"14","author":"V Goz","year":"2014","journal-title":"Spine J"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"e1040","DOI":"10.1016\/j.wneu.2017.11.159","article-title":"Spontaneous spinal arthrodesis in stand-alone percutaneous pedicle screw fixation without in situ fusion in patients with lumbar segmental instability: long-term clinical, radiologic, and functional outcomes","volume":"110","author":"R Gazzeri","year":"2018","journal-title":"World Neurosurg"},{"issue":"04","key":"ref29","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1007\/s10143-012-0394-1","article-title":"Role of lumbar interspinous distraction on the neural elements","volume":"35","author":"A Alfieri","year":"2012","journal-title":"Neurosurg Rev"},{"issue":"20","key":"ref30","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1097\/BRS.0b013e3182077005","article-title":"Change in sagittal balance with placement of an interspinous spacer","volume":"36","author":"L M Schulte","year":"2011","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1016\/j.wneu.2017.07.045","article-title":"Bony lateral recess stenosis and other radiographic predictors of failed indirect decompression via extreme lateral interbody fusion: multi-institutional analysis of 101 consecutive spinal levels","volume":"106","author":"T Y Wang","year":"2017","journal-title":"World Neurosurg"},{"issue":"05","key":"ref32","doi-asserted-by":"crossref","first-page":"403","DOI":"10.3171\/SPI.2008.9.11.403","article-title":"Perioperative complications of primary posterior lumbar interbody fusion for nonisthmic spondylolisthesis: analysis of risk factors","volume":"9","author":"N Hosono","year":"2008","journal-title":"J Neurosurg Spine"},{"issue":"05","key":"ref33","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1007\/s00264-007-0367-0","article-title":"In situ instrumented posterolateral fusion without decompression in symptomatic low-grade isthmic spondylolisthesis in adults","volume":"32","author":"M F Butt","year":"2008","journal-title":"Int Orthop"},{"key":"ref34","first-page":"13","article-title":"Anatomic features of the paramedian muscle-splitting approaches to the lumbar spine","volume":"66","author":"D J Hoh","year":"2010","journal-title":"Neurosurgery"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"e1069","DOI":"10.1016\/j.wneu.2018.10.229","article-title":"Severe lumbar intervertebral disc degeneration is associated with Modic changes and fatty infiltration in the paraspinal muscles at all lumbar levels, except L1\u2013L2: a cross-sectional analysis of 50 symptomatic women and 50 age-matched symptomatic men","volume":"122","author":"E E \u00d6zcan-Ek\u015fi","year":"2019","journal-title":"World Neurosurg"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"106120","DOI":"10.1016\/j.clineuro.2020.106120","article-title":"Proposal for a new scoring system for spinal degeneration: Mo-Fi-Disc","volume":"198","author":"M\u015e Ek\u015fi","year":"2020","journal-title":"Clin Neurol Neurosurg"},{"issue":"251","key":"ref37","doi-asserted-by":"crossref","first-page":"120","DOI":"10.3109\/17453679309160140","article-title":"Meta-analysis of the results of lumbar spine fusion","volume":"251","author":"J A Turner","year":"1993","journal-title":"Acta Orthop Scand Suppl"},{"issue":"08","key":"ref38","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1056\/NEJMoa0707136","article-title":"Surgical versus nonsurgical therapy for lumbar spinal stenosis","volume":"358","author":"J N Weinstein","year":"2008","journal-title":"N Engl J Med"},{"key":"ref39","first-page":"e934985","article-title":"Oblique lateral interbody fusion with anterolateral screw fixation is as effective as with posterior percutaneous pedicle screw fixation in treating single-segment mild degenerative lumbar diseases","volume":"28","author":"Y Guo","year":"2022","journal-title":"Med Sci Monit"},{"issue":"03","key":"ref40","doi-asserted-by":"crossref","first-page":"E2","DOI":"10.3171\/2020.6.FOCUS20374","article-title":"Functional and radiological outcome of anterior retroperitoneal versus posterior transforaminal interbody fusion in the management of single-level lumbar degenerative disease","volume":"49","author":"R Bassani","year":"2020","journal-title":"Neurosurg Focus"},{"issue":"03","key":"ref41","doi-asserted-by":"crossref","first-page":"E14","DOI":"10.3171\/2020.6.FOCUS20335","article-title":"The anterior-to-psoas approach for interbody fusion at the L5-S1 segment: clinical and radiological outcomes","volume":"49","author":"M Miscusi","year":"2020","journal-title":"Neurosurg Focus"}],"container-title":["Journal of Neurological Surgery Part A: Central European Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-1777751.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T23:34:42Z","timestamp":1735947282000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-1777751"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,19]]},"references-count":41,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2025,1,3]]},"published-print":{"date-parts":[[2025,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-1777751","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2193-6315","2193-6323"],"issn-type":[{"value":"2193-6315","type":"print"},{"value":"2193-6323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,19]]}}}