DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20182733

Comparative study between functional outcome of lumbar canal stenosis treated with surgical decompression by laminectomy and unilateral partial hemi laminectomy approaches

K. Ramesh, G. Vimalan

Abstract


Background: Lumbar spinal canal stenosis may eventually cause signs of intermittent neurogenic claudication. The surgical options include procedures such as midline decompression by laminectomy and different kinds of unilateral and bilateral fenestrations and partial or full hemi laminectomies. The aim of the study is to unilateral decompressive approach provides the sufficient decompression; less invasive unilateral procedure, which preserves posterior musculoligamentous complex and bony structures reduce associated morbidity.

Methods: 41 patients underwent preoperative assessment of Japanese orthopaedic association score (JOA Score), Neurogenic claudication outcome scores (NCOS), visual analogy scale for back pain and neurogenic claudication. Patients were randomized to undergo either unilateral decompression by partial hemi laminectomy or CMD (CMD) by laminectomy. 20 patients was randomized into unilateral decompression by partial hemi laminectomy group and 21 patients into CMD (CMD) by laminectomy group.

Results: The mean JOA recovery rate was 50.61% for the unilateral decompression group and 52.12% for the CMD group. Notably, 62% of CMD group had good or excellent outcome while 70% of unilateral decompression group had a good or excellent outcome.

Conclusions: In our study, unilateral decompression by a partial hemi laminectomy provides minimal exposure for decompression in lumbar canal stenosis while preserving musculoligamentous attachments of the posterior elements of the spine and good postoperative results after one year with favorable outcomes of at least 70%. 


Keywords


Lumbar canal stenosis, CMD, Degenerative lumbar spinal stenosis

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References


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