Laminectomy decompression under microscope for lumbar spinal stenosis

Abstract

Objective To investigate the efficacy of laminectomy decompression under microscope for lumbar spinal stenosis. Methods A retrospective study was conducted regarding 13 patients with lumbar spinal stenosis who were admitted to Department of Neurosurgery, Xiangya Hospital, Central South University, from April 2015 to April 2016 and underwent unilateral/bilateral laminectomy decompression under microscope.Among the 13 patients of lumbar stenosis, 8 cases involved single segment, 3 invovled 2 segments and 2 involved 3 segments.The segments operated on were L2~3 in 2 cases, L3~4 in 5 cases , L4~5 in 10 cases and L5-S1 in 3 cases. The preoperative and postoperative Visual Analogue Scale (VAS) scores were used to evaluate the pain relief. Postoperative follow-up on a regular basis was conducted including examinations of magnetic resonance imaging (MRI), computed tomography (CT) and dynamic spine X-ray. Results The operation time in this group was 1.5-5.5 h , the intraoperative blood loss measured 50-400 ml, and postoperative hospital stay was 8-21 d. Back and leg pain in all patients were significantly improved after operation. The postoperative VAS score was 1.38 and decreased from preoperative 4.23. No nerve injury or cerebrospinal fluid leakage due to spinal dura tears was observed in this study. No cardiac or cerebrovascular complications occurred after surgery.Postoper-atively, chest herpes zoster in 1 case and lateral femoral cutaneous neuritis in 1 case were observed. One patient with preoperative bowel and bladder disorders began to recover after opeartion, and restored independent urination 10 days post operation. Varying degrees of ease of lower limb numbness was reported in 9 cases. Conclusions Laminectomy decompression under microscope for lumbar spinal stenosis demonstrated advantages including shorter operation time, less intraoperative blood loss and shorter hospitalization length, through which sufficient decompression and good clinical outcomes could be obtained. Further observation is needed to study its long-term effect on the stability of lumbar spine. Key words: Spinal stenosis; Microsurgery; Decompression, surgical; Treatment outcome