Abstract
BackgroundConventional posterior open lumbar surgery is associated with considerable trauma to the paraspinal muscles. Severe damage to the paraspinal muscles could cause low back pain (LBP), resulting in poor functional outcomes. Thus, several studies have proposed numerous surgical techniques that can minimize damage to the paraspinal muscles, particularly unilateral laminotomy for bilateral decompression. The purpose of this study is to compare the degree of postoperative LBP, functional outcome, and quality of life of patients between bilateral decompression via unilateral laminotomy (BDUL; group U) and conventional laminectomy (CL; group C).MethodsOf 87 patients who underwent diagnostic and decompression surgery, 50 patients who met the inclusion and exclusion criteria and were followed up for > 2 years were enrolled. The patients were asked to record their visual analog scale pain score after 6, 12, and 24 months postoperatively. BDUL was used for group U, whereas CL was used for group C. The patients were randomly divided based on one of the two techniques, and they were followed up for over 2 years. Functional outcomes were assessed by the Oswestry Disability Index (ODI), Roland–Morris Disability Questionnaire (RMDQ), and SF-36.ResultsOperation time was significantly shorter in group U than in group C (p = 0.003). At 6, 12, and 24 months, there was no significant difference between the two groups in terms of spine-related pain (all p > 0.05). Functional outcomes using ODI and RMDQ and quality of life using SF-36 were not significantly different between the groups (all p > 0.05).ConclusionsRegarding single-level decompression for degenerative lumbar spinal stenosis, group U had the advantages of shorter operation time than group C, but not in terms of back pain, functional outcome, and quality of life.
Highlights
In the absence of any improvement or deterioration following diverse conservative treatments or in the presence of neurological deficit, surgical treatment is warranted for degenerative lumbar spinal stenosis (DLSS)
Conventional posterior open lumbar surgery is associated with considerable trauma to the paraspinal muscles
This study aimed to compare the degree of postoperative low back pain (LBP), functional outcome, and quality of life of patients between bilateral decompression via unilateral laminotomy (BDUL) and conventional laminectomy (CL), which were randomly performed by a spine surgeon in patients with single-level DLSS requiring surgery
Summary
In the absence of any improvement or deterioration following diverse conservative treatments or in the presence of neurological deficit, surgical treatment is warranted for degenerative lumbar spinal stenosis (DLSS). Conventional laminectomy (CL) is usually performed for adequate decompression, but it can damage the posterior structures that provide lumbar stability during flexion. Even without substantial damage to the facet joints, severe damage to the paraspinal muscles could cause low back pain (LBP), resulting in poor functional outcomes. Severe damage to the paraspinal muscles could cause low back pain (LBP), resulting in poor functional outcomes. Several studies have proposed numerous surgical techniques that can minimize damage to the paraspinal muscles, unilateral laminotomy for bilateral decompression. The purpose of this study is to compare the degree of postoperative LBP, functional outcome, and quality of life of patients between bilateral decompression via unilateral laminotomy (BDUL; group U) and conventional laminectomy (CL; group C)
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