Abstract
ABSTRACT Objective Considering that the technique of spinous process splitting has been advocated as a less invasive treatment of lumbar stenosis, the objective of this study was to evaluate the preliminary results of this technique in the surgical treatment of lumbar canal stenosis. Methods Twenty patients with lumbar spinal canal stenosis who underwent surgical treatment for lumbar canal decompression with the spinous process splitting technique were assessed in the preoperative period and on postoperative days 1, 7 and 30 for VAS for lower back and lower limbs pain and radiographic evaluation of the operated segment. Results The mean visual analogue scale score for lumbar pain in the preoperative assessment was 4.2 ± 3.37 and 0.85 ± 0.88, 1.05 ± 1.19 and 1.15 ± 1.04 after 1, 7 and 30 postoperative days, respectively. The mean VAS score for lower limb pain was 8 ± 1.72 preoperatively, and 0.7 ± 1.13, 0.85 ± 1.04, and 1.05 ± 1 after 1, 7, and 30 postoperative days, respectively. There were no radiographic signs of instability of the vertebral segment operated in the radiographic evaluation. Conclusions Decompression of the lumbar canal through the spinous process splitting technique in patients with lumbar canal stenosis had good immediate and short-term results in relation to low back and lower limbs pain. Level of evidence IV; Therapeutic Study.
Highlights
Degenerative changes of the vertebral segment causing compression of the nerve structures inside the vertebral canal and vertebral foramen were identified long ago and reported before lumbar disc herniation.[1]The surgical treatment of lumbar canal stenosis has been performed by means of decompression of the nerve structures of the affected vertebral segment
Decompression of the nerve structures has been accomplished by removal of the lamina, facet joints, ligamentum flavum, and osteophytes of the canal and vertebral foramen.[2,3]
Laminoplasty has been performed as an alternative for decompression of the nerve structures and to preserve the continuity of the posterior vertebral elements.[4]
Summary
Degenerative changes of the vertebral segment causing compression of the nerve structures inside the vertebral canal and vertebral foramen were identified long ago and reported before lumbar disc herniation.[1]The surgical treatment of lumbar canal stenosis has been performed by means of decompression of the nerve structures of the affected vertebral segment. Degenerative changes of the vertebral segment causing compression of the nerve structures inside the vertebral canal and vertebral foramen were identified long ago and reported before lumbar disc herniation.[1]. Decompression of the nerve structures has been accomplished by removal of the lamina, facet joints, ligamentum flavum, and osteophytes of the canal and vertebral foramen.[2,3] Laminoplasty has been performed as an alternative for decompression of the nerve structures and to preserve the continuity of the posterior vertebral elements (spinous process and vertebral lamina).[4] Decompression has been classically performed by exposing the posterior vertebral elements This surgical approach promotes the detachment and retraction of the paravertebral muscles and the morbidity related to the injury to the paravertebral muscles caused by ischemia, denervation, and muscle detachment has motivated the development of less invasive surgical techniques.[2]
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