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71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

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Relevance of amyloid deposits in the ligamentum flavum and the spine muscle for the treatment of lumbar spinal stenosis

Relevanz der Amyloidose des Ligamentum flavum und der paravertebralen Muskulatur für die Behandlung lumbaler Spinalkanalstenose

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  • presenting/speaker Bogdan Pintea - Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Neurochirurgie, Bochum, Deutschland
  • Susanne Amur - Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Neurochirurgie, Bochum, Deutschland
  • Anne-Katrin Güttsches - Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Neurologie, Bochum, Deutschland
  • Konstantinos Gousias - Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Neurochirurgie, Bochum, Deutschland; Katholisches Klinikum Lünen-Werne, Neurochirurgie, Lünen, Deutschland
  • Matthias Vorgerd - Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Neurologie, Bochum, Deutschland
  • Peter Zahn - Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Anästhesie, Bochum, Deutschland
  • Ramon Martinéz-Olivera - Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Neurochirurgie, Bochum, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocP026

doi: 10.3205/20dgnc317, urn:nbn:de:0183-20dgnc3172

Published: June 26, 2020

© 2020 Pintea et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: To evaluate the relevance of the amyloid deposits in the ligamentum flavum and the spine muscle for the microsurgical treatment of lumbar spinal stenosis.

Methods: We prospectively collect data regarding the extent of lumbar spine degeneration (evidence of scoliosis, Cobb angle, evidence of spondylolisthesis, the number of lumbar segments with spinal stenosis), the health related quality of life (Oswetry Disability Index/ODI and the EQ-5D questionary) and the pain intensity on the visual analog scale (VAS) from patients assigned for microsurgical decompression of lumbar spinal stenosis. Biopsy of the ligamentum flavum and spine muscle tissue were taken during surgery. Histochemical examination of the tissue was subsequently perfomed for amyloid deposits. The patients were divided into two groups depending on the presence of amyloid deposits in the ligamentum flavum and monovariant analysis was performed to detect significant differences.

Results: 50 patients were included in the trial, 32 patients had amyloid deposits in the ligamentum flavum and 3 patients had amyloid deposits in the ligamentum flavum and the spine muscle. The extent of scoliosis/cobb angle tended to be higher in the group of patients with amyloid deposits in the ligamentum flavum (patients with amyloid deposits in the ligamentum 8° vs patients without amyloid deposits in the ligamentum flavum 4°; p= 0,089). The preoperative health related quality of life was significantly lower for the patients with amyloid deposits in the ligamentum flavum (patients with amyloid deposits in the ligamentum ODI: 48% and EQ-5D: 2,8 vs. patients without amyloid deposits in the ligamentum flavum ODI: 38%; p=0.005 and EQ-5D: 2,4; p=0.014). The pain intensity (VAS) did not differ significantly between patients with or without amyloid deposits in the ligamentum flavum.

Conclusion: Amyloid deposits in the ligamentum flavum are associated with a lower health related quality of life and a higher extent of degenerative deformity.