Open Access, Peer-reviewed
pISSN 2093-4378
eISSN 2093-4386
    J Korean Soc Spine Surg. 2004 Jun;11(2):99-103. Korean.
    Published online Jun 30, 2004.
    https://doi.org/10.4184/jkss.2004.11.2.99
    Copyright © 2004 Korean Society of Spine Surgery
    Original Article

    Bilateral Microscopic Laminotomy for Lumbar Spinal Stenosis

    Chong Suh Lee, M.D., Sung Soo Chung, M.D., Kwang Hoon Chung, M.D.,# and Sung Kyun Oh, M.D.
      • Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
      • #Department of Orthopedic Surgery, Jeju University, School of Medicine, Jeju, Korea.
    • Address reprint requests to Chong-Suh Lee, M.D. Department of Orthopedic Surgery, Samsung Medical Center Sungkyunkwan University, School of Medicine, Ilwon-Dong, Kangnam-Ku, Seoul, 135-710, Korea. Tel: 82-2-3410-3503, Fax: 82-2-3410-0061, Email: csl@smc.samsung.co.kr

    Abstract

    Study Design and Objectives

    In the treatment of lumbar spinal stenosis, a less invasive technique is preferred, for which good results have been observed. In this study, 34 patients who had undergone a bilateral microscopic laminotomy for lumbar spinal stenosis were retrospectively investigated.

    Materials and Methods

    Thirty-four patients with lumbar spinal stenosis who had undergone a bilateral microscopic laminotomy, between March 1997 and December 2000 were reviewed. The subjects comprised of 18 men and 16 women, with a median age of 46.1years. The average follow-up period was 32 months. Demographic data and the durations of back and radiating pains of these patients were analyzed. For the prognostic factors, the clinical outcomes were analyzed using the McNab's criteria, and the postoperative instability, ambulation time after surgery, hospital stay, operative time and complications reviewed.

    Results

    The analysis showed excellent, good, fair and poor results in 12, 12, 6 and 4 patients, respectively. The satisfaction rate with the surgery was over 70.6%. The average length of hospital stay, operative time and estimated intraoperative blood loss were 7.3 days, 109minutes and 160cc, respectively. A longer duration of lower back pain (p=0.0154) was associated with a poor result, whereas increasing age (p=0.1884), gender (p=1.0) and duration of radiating pain (P=0.4449) showed no statistical significance.

    Conclusion

    A bilateral microscopic laminotomy can be used as a less invasive technique for lumbar spinal stenosis, with which satisfactory results are usually achieved. It may be especially beneficial in young patient with lower back pain of only a short duration. However, late postoperative instability should be carefully observed.

    Keywords
    Lumbar spinal stenosis; Bilateral microscopic laminotomy

    Tables

    Table 1
    Results in Fair and Poor cases

    References

      1. Aryanpur J, Ducker T. Multilevel lumbar laminotomies: an alernative to laminectomy in the treatment of lumbar stenosis. Neurosurgery 1990;26:429–433.
      1. Caputy AJ, Luessenhop AJ. Long term evaluation of decompressive surgery for degenerative lumpar stenosis. J Neurosurg 1992;77:669–676.
      1. Dai LY, Ni B, Jia LS, Liu HK. Lumbar disc herniation in patients with developmental spinal stenosis. Eur Spine J 1996;5(5):308–311.
      1. Verbiest H. Developmental stenosis of the bony lumbar vertebral canal. Acta Orthop Belg 1987;53(3):37.
      1. Lee CK, Hansen HT, Weiss AB. Developmental lumbar spinal stenosis. Pathology and surgical treatment. Spine 1978 Sep;3(3):246–255.
      1. Tsai RY, Yang RS, Bray RS Jr. Microscopic Laminotomies for Degenerative Lumbar spinal stenosis. J Spinal Disord 1998;11:389–394.
      1. Eule JM, Breeze R, Kindt GW. Bilateral partial laminectomy: a treatment for lumbar spinal stenosis and midline disc herniation. Surg Neurol 1999 Oct;52(4):329–337.
        discussion 337-8.
      1. Suk SI, Lee CK, Lee CS, Kim EH, Huh MG. Cotrel-Dubousset Pedicle Screw Fixation after Posterior Decompression of Lumbar Spinal Stenosis. J Korean Orthop Assoc 1990;25:161–168.
      1. Katz JN, Lipson SJ, Brick GW, et al. Clinical correlates of patient satisfaction after laminectomy for degenerative lumbar spinal stenosis. Spine 1995;20:1155–1160.
      1. Katz JN, Lipson SJ, Larson MG, Mcinnes JM, Fossel AH, Liang MH. The outcome of Decompressive Laminectomy For Degenerative Lumbar Stenosis. J Bone joint Surg Am 1991;73:809–816.
      1. Johnsson KE, Redlund-Johnell I, Uden A, Willner S. Preoperative and postoperative instability in lumbar spinal stenosis. Spine 1989;14:591–593.
      1. Mardjetko SM, Connolly PJ, Shott S. Degenerative lumbar spondylolisthesis: A meta-analysis of the literature 1070-1993. Spine 1994;19:S2256.
      1. Herron LD, Trippi AC. L4-5 degenerative spondylolisthesis.The results of treatment by decompressive laminectomy without fusion. Spine 1989;14:534–538.
      1. Young S, Veerapen R, O'Laoire SA. Relief of lumbar canal stenosis using multilevel subarticular fenestrations as an alternative to wide laminectomy:preliminary report. Neurosurgery 1988;23:628–633.
      1. Nakai O, Ookawa A, Yamamura I. Long term roentgenographic and functional changes in patients who were treated with wide fenestration for central lumbar stenosis. J Bone Joint Surg Am 1991;73(8):1184–1191.
      1. Lee CS. Surgical treatment of lumbar spinal stenosis;decompression with fusion. J Korean Soc Spine Surg 2000;7(1):111–125.
      1. Cauchoix J, Benoist M, Chassaing V. Degenerative spondylolisthesis. Clin Orthop 1976;115:123–129.
      1. Fischgroun JS, Mackay M, Herkowitz HN, Brower R, Montomery DM, Kurz LT. Degenerative lumbar spondylolisthesis with spinal stenosis: A prospective,randomnized study comparing decompressive laminectomy and arthrodesis wiht and without spinal instrumentation. Spine 1997;22:2807–2812.
      1. Postacchini F. Spine Update: Surgical management of lumbar spinal stenosis. Spine 1996;21:970–981.
      1. Johnsson KE, Willner S, Johnsson K. Postoperative instability after decompression for lumbar spinal stenosis. Spine 1986;11:107–110.
      1. Lee CK. Lumbar spinal instability after extensive posterior spinal decompression. Spine 1983;8:429–433.
    Cited by
    Crossref 2
    Google Scholar 
    MeSH Terms
    Female
    Follow-Up Studies
    Humans
    Laminectomy*
    Length of Stay
    Low Back Pain
    Male
    Operative Time
    Retrospective Studies
    Spinal Stenosis*
    Walking
    Metrics
    Share
    Tables
    slide

    1 / 1

    PERMALINK