Minimally Invasive Laminectomy for Lumbar Spinal Stenosis in Patients with and without Preoperative Spondylolisthesis: Clinical Outcome and Reoperation Rate

Abstract

Introduction Surgical decompression is the intervention of choice for lumbar spinal stenosis (LSS) when nonoperative treatment has failed. Standard open laminectomy is an effective procedure. Minimally invasive laminectomy through tubular retractors is an alternative procedure. The aim of our cohort study was to evaluate the clinical and radiographic outcome of this procedure in LSS patients with or without preoperative spondylolisthesis. Materials and Methods Patients with LSS without spondylolisthesis and with stable spondylolisthesis who underwent MIS tubular laminectomy between 2004 and 2011 were included. Demographic, perioperative, and radiographic data were collected. Clinical outcome was evaluated by Oswestry disability index (ODI) and visual analog scale (VAS) scores, as well as by MacNab criteria. Results In a total of 110 patients, preoperative spondylolisthesis at the level of spinal stenosis was present in 52.5%. ODI and VAS pain scores at a mean follow-up of 28.8 months revealed a median improvement of 16% in ODI, 2.75 in VAS back, and 3 in VAS leg scores, compared with the preoperative baseline ( p < 0.0001). The reoperation rate requiring fusion was 3.5%. Patients with and without preoperative spondylolisthesis had no significant differences in their clinical outcome or the reoperation rate. Conclusion MIS laminectomy is an effective procedure for treatment of LSS. Reoperation rates for instability are lower than reported after open laminectomy. Functional improvement is similar in patients with and without preoperative spondylolisthesis. This procedure can be a viable alternative to open laminectomy. Routine fusion may not be indicated in all patients with LSS and spondylolisthesis. Disclosure of Interest None declared