Abstract
BackgroundThe quest for better patient outcomes is driving to the development of minimally invasive spine surgical techniques. There are several evidences on the use of microsurgical decompression surgery for degenerative lumbar spine stenosis; however, few of these studies compared their outcomes with the traditional laminectomy technique.ObjectivesThe aim of our study was to compare outcomes following microsurgical decompression via unilateral laminotomy for bilateral decompression (ULBD) of the spinal canal to the standard open laminectomy for cases with lumbar spinal stenosis.Subjects and methodsCases were divided in two groups. Group (A) cases were operated by conventional full laminectomy; Group (B) cases were operated by (ULBD) technique. Results from both groups were compared regarding duration of surgery, blood loss, perioperative complication, and postoperative outcome and patient satisfaction.ResultsThere was no statistically significant difference between both groups regarding the improvement of visual pain analogue, while improvement of neurogenic claudication outcome score was significant in group (B) than group (A). Seventy-three percent of group (A) cases and 80% of group (B) stated that surgery met their expectations and were satisfied from the outcome.ConclusionComparing ULBD with traditional laminectomy showed the efficacy of the minimally invasive technique in obtaining good surgical outcome and patient satisfaction. There was no statistically significant difference between both groups regarding the occurrence of complications The ULBD technique was found to respect the posterior spinal integrity and musculature, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods than the open laminectomy technique.
Highlights
Degenerative lumbar spinal stenosis (LSS) is a progressive degenerative disease, more commonly to occur over age of 60 years
There was no statistically significant difference between both groups regarding the improvement of visual pain analogue, while improvement of neurogenic claudication outcome score was significant in group (B) than group (A)
There was no statistically significant difference between both groups regarding the occurrence of complications The unilateral laminotomy for bilateral decompression (ULBD) technique was found to respect the posterior spinal integrity and musculature, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods than the open laminectomy technique
Summary
Degenerative lumbar spinal stenosis (LSS) is a progressive degenerative disease, more commonly to occur over age of 60 years. Causes of degenerative LSS include broad base disc bulging, ligamentum flavum hypertrophy, and degenerative facet joint disease. It significantly impacts the quality of life in performing the daily activities and can lead to progressive disability [1]. The primary treatment line for most patients with lumbar spinal stenosis is non-surgical [3]. The quest for better patient outcomes is driving to the development of minimally invasive spine surgical techniques. There are several evidences on the use of microsurgical decompression surgery for degenerative lumbar spine stenosis; few of these studies compared their outcomes with the traditional laminectomy technique
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