Microscopic decompression for lumbar spinal canal stenosis

Abstract

Study designA retrospective review and prospective follow-up were performed of 106 patients who had undergone microscopic decompressive surgery without fusion in the year 2006 at Munich Spine Center, Germany.ObjectiveThis study aimed to determine the 4–5-year outcome of microscopic unilateral laminotomy for bilateral decompression in degenerative lumbar spinal stenosis and to detect the possible predictors of the surgical outcome.Summary of background dataThere is limited information on the impact of surgery for lumbar spinal stenosis on symptoms, functional status, and satisfaction, as well as reoperation.Patients and methodsPatients were considered eligible for the study if they had clinical and radiographic evidence of degenerative lumbar spinal stenosis, including patients with degenerative spondylolisthesis type 1 according to Myerding and patients with degenerative scoliosis. All patients underwent microscopic decompressive surgery without fusion in the year 2006 at the Munich Spine Center, Germany. One hundred and six patients were available for follow-up during the year 2010.ResultsAt 4–5 years after the operation, 76 (71.7%) patients were satisfied with the surgical outcome. The overall complication rate was 12.2%. 23 (21%) patients required a second operative procedure, whereas three (2.8%) patients required a third operative procedure after the index operation. Two of the 23 patients who had second operations had presumed instability and underwent fusion.ConclusionUnilateral laminotomy for bilateral decompression is an adequate microsurgical technique for decompression of lumbar spinal stenosis that minimizes operative invasiveness and tissue trauma while maximizing preservation of the spinal integrity and stability. Secondary postoperative instability is avoided and excellent long-term clinical outcome could be expected.