Clinical and Radiological Outcomes of Spinous Process-Splitting Laminectomy for Lumbar Spinal Stenosis at 1 Year: A Preliminary Report of a Single-Institution Experience

Abstract

Objective: This study investigated the clinical and radiological outcomes of lumbar spinous process-splitting laminectomy (LSPSL) performed to treat lumbar spinal stenosis at a single institution in Korea. Methods: A retrospective review was conducted of patients who underwent LSPSL for lumbar spinal stenosis between June 2020 and February 2022, with a minimum 1-year follow-up. Clinical outcomes were assessed using the visual analogue scale (VAS), Oswestry Disability Index (ODI), European quality of life - 5 dimensions - 5 levels (EQ-5D-5L), European quality of life VAS (EQ-VAS), and modified MacNab criteria. One year after surgery, radiological outcomes were evaluated through computed tomography scan to assess the spinolaminar bone union rate and patterns.Results: Out of 38 patients, data from 30 patients (male:female = 17:13) and 36 surgical levels were analyzed. The mean age was 67 years (range, 46–88 years). The preoperative mean leg VAS score and ODI significantly decreased at the 1-year postoperative follow-up (leg VAS, 6.6–3.8; p = 0.001; ODI, 19.3–10.9, p = 0.006). The EQ-5D-5L index and EQ-VAS also significantly improved (0.52–0.77, p < 0.001; 50.8–67.1, p = 0.018; respectively). Using the modified MacNab criteria, the study reported excellent and good outcomes in 80% of patients at the 1-year follow-up, with no serious complications observed. The overall spinolaminar union rate was 77.8% (complete union, 58.3%; partial union 19.4%).Conclusion: LSPSL was found to provide favorable clinical outcomes and a satisfactory rate of posterior bony structure restoration for lumbar spinal stenosis, making it a feasible treatment option.