Abstract

This study was to evaluate the morphological features of degenerative spinal stenosis and adequacy of lateral canal stenosis decompression via unilateral and bilateral laminectomy. Measurements of facet joint angulation (FJA), mid facet point (MFP), mid facet point distance (MFPD), the narrowest point of the lateral spinal canal (NPLC) and the narrowest point of the lateral spinal canal distance (NPLCD) were performed. At L4L5 of the right and left side, the mean distance between the lateral border of the dura and MFP was 1.0 ± 0.2 cm and 1.0 ± 0.3cm respectively. The mean NPLC was seen at 0.7 ± 0.3 and 0.7 ± 0.3 cm cm from the dura. At L5S1 of the right and left side, the mean distance between the lateral border of the dura and MFP was 1.2± 0.2 and 1.3 ± 0.2 cm respectively. The mean NPLC was seen at 0.8 ± 0.4 and 0.9 ± 0.5 cm from the dura. Unilateral laminectomy may result in incomplete decompression.

Highlights

  • Degenerative lumbar disease with lateral canal stenosis among elderly patients is not uncommon and most commonly involved the L4-L5 and L5-S1 levels .1-3 It represents different stages of degenerated spinal disease with the involvement of intervertebral discs, vertebra bodies, ligamentum flavum, posterior longitudinal ligament, facet joints and the spinal venous plexus .3-6Presence of lateral stenosis is often missed or underestimated

  • Lateral canal stenosis causes compression on the nerve root that passes through the affected intervertebral foramen

  • The aim of this study is to study the morphology of degenerative lateral spinal stenosis

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Summary

Introduction

Degenerative lumbar disease with lateral canal stenosis among elderly patients is not uncommon and most commonly involved the L4-L5 and L5-S1 levels .1-3 It represents different stages of degenerated spinal disease with the involvement of intervertebral discs, vertebra bodies, ligamentum flavum, posterior longitudinal ligament, facet joints and the spinal venous plexus .3-6Presence of lateral stenosis is often missed or underestimated. Degenerative lumbar disease with lateral canal stenosis among elderly patients is not uncommon and most commonly involved the L4-L5 and L5-S1 levels .1-3. It represents different stages of degenerated spinal disease with the involvement of intervertebral discs, vertebra bodies, ligamentum flavum, posterior longitudinal ligament, facet joints and the spinal venous plexus .3-6. Lateral canal stenosis causes compression on the nerve root that passes through the affected intervertebral foramen. Failure to address the lateral stenosis component of the patients’ symptoms had contributed to the increased rate of poor surgical outcomes associated with incomplete decompression. The contributing factors for these problems include lack of understanding of the pathophysiology, its importance in the management and inaccurate reported MRI findings 7, 8

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