Lumbar Laminoplasty Research Articles

What's New in Spine Surgery.

What's New in Spine Surgery.

Exoscopic transtubular image-guided lumbar laminoplasty: surgical results in a consecutive series of patients.

Exoscopic transtubular image-guided lumbar laminoplasty: surgical results in a consecutive series of patients.

Lumbosacral Nevus Simplex in a Newborn Girl with an Asymmetrical Y-Shaped Gluteal Cleft

Lumbosacral Nevus Simplex in a Newborn Girl with an Asymmetrical Y-Shaped Gluteal Cleft

Erector Spinae Plane Block for Perioperative Pain Control and Short-term Outcomes in Lumbar Laminoplasty: A Randomized Clinical Trial.

BackgroundSpine surgery causes severe pain and can be associated with significant opioid utilization; however, the evidence for opioid-sparing analgesic techniques such as erector spinae plane (ESP) block from controlled studies is limited. We aimed to investigate the analgesic effects of ESP block in lumbar laminoplasty.MethodsIn this prospective, double-blind, controlled single-center trial, 62 consecutive elective lumbar laminoplasty patients were randomized into either a control group (Group G, N=32) or a treatment group (Group E, N=30). Group G received general anesthesia and multimodal analgesia, similar to group E, while Group E received additional bilateral ESP block after induction of general anesthesia. The primary outcome was postoperative pain scores for the first 48 h after surgery, and the secondary outcomes analyzed included intraoperative anesthetic usage, perioperative analgesic consumption, return of bowel function and satisfaction for acute pain management indicated by overall benefit of analgesia score (OBAS).ResultsSignificant differences in pain scores over time were found between the two groups (P=0.010), with Group E patients having significantly lower pain scores than Group G during the first six hours (P=0.000). The opioid consumption in Group G was significantly higher than in Group E both intraoperatively (P=0.000) and postoperatively (P=0.0005). Group E patients had lower intraoperative sevoflurane requirement, improved satisfaction with pain management, and earlier return of bowel function than Group G patients.ConclusionESP block is effective in reducing postoperative pain scores and lowering opioid utilization (both intraoperatively and postoperatively), resulting in improved patient satisfaction for pain management in lumbar laminoplasty.

Lumbar Laminoplasty for Resection of Myxopapillary Ependymoma of the Conus Medullaris: 2-Dimensional Operative Video.

Myxopapillary ependymomas are slow-growing tumors that are located almost exclusively in the region of the conus medullaris, cauda equina, and filum terminale of the spinal cord. Surgical intervention achieving a gross total resection is the main treatment modality. If, however, a gross total resection cannot be achieved, surgery is augmented with radiation therapy. In this video, we present the case of a 27-yr-old male with persistent back pain and radiculopathy who was found to have a myxopapillary ependymoma that was adherent to the conus. Preoperative imaging demonstrated that the tumor was displacing the conus and nerve roots ventrally. A laminoplasty at L1-L2 was performed with near-total resection because of the intimate involvement of neural tissue. The key features of the video include performing laminoplasty and rationale, and performing maximum safe tumor resection with a combination of bipolar cautery, suction, and ultrasonic aspiration augmented with frequent stimulation, gel foam pledgets intradurally, and achieving a watertight closure of the dura and fascia. The patient tolerated the surgery well without any complications. Given his gross residual disease along the conus and young age, he was at a high risk for continued tumor growth without adjuvant therapy, with a recurrence rate of roughly 33% to 45% in patients who underwent subtotal resection. With the addition of adjuvant radiation therapy, the recurrence rate is 20% to 29%.1,2 He was discharged to home with a plan for conventional fractionated external beam radiation. At the most recent follow-up, he reported decreased back pain and radiculopathy. Appropriate patient consent was obtained.

Building block osteotomy, a new back muscle-preserving laminoplasty for lumbar spinal stenosis

In order to preserve paravertebral muscles and posterior ligaments complex (PLC), this paper proposes a new lumbar laminoplasty surgery for lumbar spinal stenosis (LSS). According to the anatomy of back muscles insertions, building block osteotomy (BBO) which aimed to achieve precise osteotomy and reconstruction based on modular design theory was firstly put forward, and supposed to be achieved by an ultrasound bone scalpel (UBS). In details, lumbar spinous processes are longitudinally split, then supraspinous and interspinous ligaments are sharply cut off longitudinally. After converting to lumbar flexion, lamina osteotomy is innovatively finished by an UBS through interspinous space. After decompression, hollow screws are firstly suggested to be used on each side to fix lamina and spinous processes, and PLC is reconstructed by interrupted suture. Feasibility of this method is evaluated in details. Challenges, advantages and disadvantages are also discussed.

Complications of full-endoscopic lumbar laminoplasty for lumbar spinal canal stenosis

Complications of full-endoscopic lumbar laminoplasty for lumbar spinal canal stenosis

Effect of body mass index on surgical times of lumbar laminoplasty and lower limb arthroplasties

BackgroundObesity is an important factor affecting incidence and development of musculoskeletal degenerative changes. In addition, obese patients are considered less favorable surgical candidates for decompression surgery in degenerative lumbar spinal canal stenosis and lower limb arthroplasty. The purpose was to assess disease characteristics of lumbar spinal canal stenosis as well as lower limb osteoarthritis, and to investigate surgical times based on body mass index (BMI) in lumbar decompressive surgery and lower limb arthroplasties.MethodsA total of 1161 patients with a diagnosis of lumbar canal stenosis (LCS), hip osteoarthritis (HOA) and knee osteoarthritis (KOA) were enrolled. The present investigation was conducted as a retrospective study using routinely collected data. All patients underwent primary decompressive surgery (laminoplasty: LAM) or lower limb arthroplasty (total hip arthroplasty: THA and total knee arthroplasty: TKA). All of the patients were divided into 3 groups based on BMI (kg/m2) (Group A: ≤ 24.9; Group B: 25–29.9; Group C: ≥ 30) within each disease category. To assess disease characteristics, age, gender, and BMI were evaluated for each disease category. Moreover, surgical times for LAM, THA and TKA were also assessed based on BMI classification.ResultsA total of 269, 470, and 422 patients were allocated to the HOA category, the KOA category, and the LCS category, respectively. The KOA category included the oldest patients and largest BMI, compared to the HOA and the LCS categories. Regarding gender difference, LCS was more common in males than in females, while opposite phenomenon was observed in the HOA and the KOA categories. The heaviest group (Group C) was significantly younger than Groups A or B in TKA and LAM. Surgical time was significantly longer in patients with overweight or obese patients than in those with normal weight in TKA and LAM, while BMI didn’t affect the time in THA.ConclusionsDisease characteristics of the KOA category and the LCS category were notably affected by BMI, and surgical times in TKA and LAM were significantly longer for overweight or obese patients, whereas THA was less affected by BMI concerning disease characteristics and surgical time.

RETRACTED: Thoracolumbar interfascial plane block provides effective perioperative pain relief for patients undergoing lumbar spinal surgery; a prospective, randomized and double blinded trial

Background: Although bilateral ultrasound-guided thoracolumbar interfascial plane (TLIP) block provides effective analgesia to the lumbar spinal region, a few previous studies for the TLIP block have only been reported up to the present. We aimed to study whether the TLIP block in combination with general anesthesia would provide more effective pain relief compared to general anesthesia alone. Prospective randomized controlled trial. Operation and recovery room, hospital ward. Seventy-two patients undergoing primary lumbar laminoplasty of less than three levels between May 2016 and April 2017. Seventy-two patients undergoing primary lumbar laminoplasty of less than three levels were randomly allocated to receive either the TLIP block combined with general anesthesia (T group, n = 35) or general anesthesia alone (C group, n = 34). The primary outcome measured the cumulative amount of fentanyl delivered to the patients through PCA within 48 h after the end of surgery. Secondary outcomes measured the number of delivered and requested PCA doses and VAS pain scores at the surgical site obtained at rest as well as with movement at specific time points within 48 h after the surgery. During the first 48 h after surgery, the cumulative amount of delivered fentanyl (mean [standard deviation]) (μg) was lower in the T group (198.3 [103.1]) (μg) than in the C group (452.9 [175.4]) (μg) (P < 0.001). The number of delivered and requested PCA doses and the VAS pain scores was also lower in the T group than in the C group at all time points (all data were less than P < 0.05). Bilateral TLIP block combined with general anesthesia provides more effective perioperative pain relief than that provided by general anesthesia alone in patients who undergo lumbar spinal surgery.

Evaluation of result of lumbar laminoplasty for multilevel lumbar canal stenosis

The aim of our study is to evaluate the clinical and functional outcome following lumbar laminoplasty with posterior element reconstruction with mini-plate and screws for multilevel lumbar canal stenosis. This study was done on 40 patients (18 males and 22 females) of degenerative multilevel lumber canal stenosis patients underwent open double door lumbar laminoplasty with posterior element reconstruction with mini-plate and screws from January 2015 to June 2018. Thirty four patients underwent surgery for 2 level involvement and 6 underwent for 3 level involvement of lumbar canal stenosis. The mean post-operative hospital stay was 5.2 ± 1.1 days. Per-operative complication was dural tear in 2 cases. Pre-operative mean VAS score of back pain and leg pain were 7.0 ± 0.7 and 7.2 ± 1.1 which were significantly reduced to 1.0 ± 0.2 and 1.0 ± 0.8 respectively at final follow-up. All patients were followed-up for minimum 1 year. Pre-operative mean Japanese Orthopedic Association score was 8.6 ± 2.2 which was significantly increased to 14.8 ± 0.4 after 12 months of surgery. Pre-operative mean Oswestry Disability Index was 34.4 ± 3.0 which was significantly reduced to 8.5 ± 2.2 after 12 months of surgery. The outcome of lumbar laminoplasty with posterior element reconstruction with mini-plate and screws for multilevel lumbar canal stenosis show good result and can be one of the good option for the treatment for multilevel lumbar canal stenosis.

Efficacy of the Thoracolumbar Interfascial Plane Block for Lumbar Laminoplasty: A Retrospective Study.

Study DesignThis paper was a single center-based retrospective study with prospective data collection.PurposeCompared with other surgeries, limited options are available for perioperative pain management in spinal surgery. Therefore, we aimed to identify new pain management in this study.Overview of LiteratureThe thoracolumbar interfascial plane (TLIP) block has been reported to provide effective regional analgesia in the lumbar region. This study investigated the efficacy of the TLIP block for pain management in lumbar laminoplasty.MethodsWe investigated patients who underwent lumbar laminoplasty for the treatment of lumbar spinal canal stenosis from April to October 2015. Patients with secondary surgery or surgery involving more than four intervertebral spaces were excluded. The primary outcome measure was the pain scale score within 48 hours after the surgery. The secondary outcomes were the number of additional analgesic drugs used and the number of patients complaining of complications, such as nausea and vomiting, within 24 hours after the surgery.ResultsWe retrospectively assessed the data of 44 patients who underwent lumbar laminoplasty. Of these, 25 patients received only general anesthesia (G group), whereas 19 patients received the TLIP block along with general anesthesia (T group). Compared with the G group, the T group reported lower pain scores for pain at 1, 2, 4, and 24 hours postoperatively. Moreover, the number of patients who received the additional analgesic pentazocine was lower in the T group than in the G group. The two groups showed no significant differences in the incidence of complications.ConclusionsThe TLIP block provides effective analgesia for 24 hours postoperatively in patients undergoing lumbar laminoplasty.

Replacement of Vertebral Lamina (Laminoplasty) in Surgery for Lumbar Isthmic Spondylolisthesis: 5-Year Follow-Up Results.

Study DesignA review of clinical and radiological outcomes of lumbar laminoplasty (LL) for the treatment of isthmic spondylolisthesis (ISL).PurposeThe single session performance of posterior lumbar interbody fusion with allograft in the anterior column and providing the realignment of the vertebrae was presented as a preliminary report earlier.Overview of LiteratureLong-term surgical outcome of cervical laminoplasty in patients has been reported. But, outcome of LL in patients is unclear.MethodsThe long-term (5 years) year follow-up results of the LL technique are reported in this retrospective study. All patients underwent preoperative and postoperative direct X-ray, computed tomography, and magnetic resonance imaging. The patients that did not respond to conservative treatment were operated. Twenty-one (52.5%) female and 19 (47.5%) male patients were included.ResultsMean age was 43,5 years (ranges, 22–57 years). The most common symptoms were low back pain (89%), pelvic and leg pain (69%) and reduction in walking distance (65%). A total of 180 pedicle screws were inserted in 40 patients; posterior lumbar interbody fusion and laminoplasty with reduction was performed in 20 patients for L4–L5, 12 patients for L5–S1, 4 patients for L3–L4–L5 and 4 patients for L4–L5-S1. Ten (25%) patients with ILL had accompanying spinal stenosis. The difference between preoperative and postoperative sagittal plane rotation and dislocation degrees and disc space heights were statistically significant in all patients (p<0.05). Solid grade 4 fusion was observed in 38 patients; in only 2 patients grade 2 pseudoarthrosis developed (5%), but these patients were asymptomatic. Visual analog scale, Prolo economical and functional scale was examined with an average follow-up 5.5 years.ConclusionsLL technique has the advantages of shorter duration of operation, lack of graft donor site complications, protection of posterior column osseoligamentous structures and achievement of high fusion rates in one session.

Use of lumbar laminoplasty vs. laminotomy for transection of the filum terminale does not affect early complication rates or postoperative course.

Various techniques are used for spinal cord untethering. The purpose of this study was to compare patient characteristics, postoperative course, and early complications after laminotomy vs. laminoplasty for transection of the filum terminale for tethered cord release. Retrospective analysis of clinical and magnetic resonance imaging data was undertaken for all patients (<18 years) who underwent tethered cord release by transection of the filum terminale at Oregon Health & Science University, Doernbecher Children's Hospital, from 2000 to 2011. Data from two hundred and forty-eight patients were analyzed. Mean age was 5.2 years (range 0.3 to 16.8 years). Access to the thecal space during surgery was achieved using laminotomy or laminoplasty in 82 (33.1 %) and 166 (66.9 %) patients, respectively. Laminoplasty patients were significantly younger than laminotomy patients (3.2 vs. 9.3 years, p<0.0001); other clinical and radiographic characteristics were similar between the groups. Nine patients (3.6 %) experienced early complications, including cerebrospinal fluid leak (n=2), suprafascial infection requiring surgical management and intravenous (IV) antibiotics (n=3) or IV antibiotics alone (n=1), a small area of peri-incisional cutaneous necrosis (n=1), perioperative seizures (n=1), and mild, transient malignant hyperthermia (n=1). There was no difference in the number of early complications between the two groups. Univariate and multivariate analyses revealed no significant risk factor for postoperative complication associated with technique. As judged by caregivers, independent of surgical technique, 97 % of patients improved after surgery. There was no difference in complication risk when performing transection of the filum terminale for tethered cord release using laminotomy or laminoplasty.

Extramedullary Myxopapillary Ependymoma of the Filum Terminale Associated With Syringomyelia: A Case Report

Abstract Aim: Ependymomas compose the majority of all intradural intramedullary spinal lesions. Filum terminale lesions are rarely associated with syringomyelia. Here we describe a case of extramedullary myxopapillary ependymoma associated with extensive syringomyelia located in the filum terminale. Material and Methods: A 34-year-old man admitted to our clinic with complaints of bilateral leg weakness, back pain and urinary dysfunction. The magnetic resonance imaging (MRI) of the patient showed us a contrast enhanced intraspinal mass at the level of L2 with a syringomyelia extending from L2 level to Th7 level. Results: The patient was operated via lumbar laminoplasty and tumor was totally resected. Conclusion: The removal of tumor is also sufficient for the resolution of syringomyelia and no additional procedure is essential for the treatment of syringomyelia in such cases. This is the first case of extramedullary tumors of the cauda equine with extensive syringomyelia.

Success and Failure of Minimally Invasive Decompression for Focal Lumbar Spinal Stenosis in Patients With and Without Deformity

Observational cohort study. Retrospective review of prospectively collected outcomes data. The purpose of this study was to evaluate the clinical efficacy of minimally invasive (MIS) decompression for focal lumbar spinal stenosis (FLSS) in patients with and without deformity. MIS, facet-preserving decompression has the potential of offering a significantly less morbid alternative to decompression and fusion in patients with leg dominant symptoms from degenerative spondylolisthesis and/or scoliosis. Single surgeon, consecutive series (n=75), evaluated over 5 years. All patients had MIS lumbar laminoplasty (bilateral decompression from a unilateral approach) for FLSS (1-2 level). Patients had leg dominant, claudicant/radicular pain. Patients were divided into 4 groups: (A) stenosis with no deformity, n=22; (B) stenosis with spondylolisthesis only, n=25; (C) stenosis with scoliosis, n=16; and (D) stenosis combined with spondylolisthesis and scoliosis, n=12. The primary clinical outcome measures were the Oswestry Disability Index (ODI) and surgical revision rate. Preoperative and postoperative standing radiographs were assessed. The average age was 68 years (40-89) with a mean time from surgery of 36.5 months (18-68). Average clinical improvement in ODI was 49.5% to 23.9% [mean postoperative follow-up of 31.8 months (24-72): group A=mean of 34.6; B=28.9; C=32.7; D=30 months]. Incidence of preoperative grade I spondylolisthesis was 46%. Spondylolisthesis progression (mean=8.4%) occurred in 9 patients and 2 patients developed spondylolisthesis. Overall revision rate was 10% [repeat decompression alone (n=2) and decompression and fusion (n=6)]. Subgroup analysis of preoperative and postoperative ODI and revision rate revealed (A) 48% to 18.7%, 0%; (B) 48% to 24.6%, 4%; (C) 50.7% to 31.5%; 25%; and (D) 53% to 22%, 25%, respectively. The revision rate for patient with scoliosis (C+D) was significant (P=0.0035) compared with those without. Six of the 8 revised patients had a preoperative lateral (rotatory) listhesis (3 in C and 3 in D). MIS decompression alone for leg dominant symptoms is a clinically effective procedure in the majority of patients including those with degenerative spondylolisthesis or scoliosis. However, patients with scoliosis, particularly those with lateral listhesis, have a significantly higher revision rate that needs to be considered in operative decision-making.

Thoracic and lumbar laminoplasty using a translaminar screw: morphometric study and technique

The aim of this study was to describe a novel technique for laminoplasty in which translaminar screws are used in the thoracic and lumbar spine. The authors first performed a morphometric study in 20 control individuals using 3D reconstructed CT scans and spine simulation software to measure the lengths and diameters of the spaces available for translaminar screw placement from the T-1 to S-1. Based on the results of the morphometric study, the authors then attempted translaminar screw fixation in 5 patients (April 2007-July 2007) after en bloc laminectomy in the thoracic and lumbar regions. All patients had intradural lesions: 3 schwannomas, 1 cavernoma, and 1 arachnoid cyst. The morphometric study in control individuals revealed that the safe trajectories for simulated screws measured 25-30 mm in length and 8-11 mm in diameter in the thoracic region (T1-12) and 26-34 mm in length and 6-7 mm in diameter in the lumbosacral region (L1-S1). This morphometric and simulation study showed that translaminar screw placement would be possible in practice. Five patients underwent en bloc laminoplasty and translaminar screw fixation in which the screws measured 2.7 mm in diameter and 24 or 26 mm in length. Sixteen attempts at translaminar fixation were made in 8 vertebrae. Fourteen translaminar screws were successfully placed at the thoracic and lumbar levels. Two microplates had to be used because the laminae were too thin and narrow after further laminectomy with undercutting. There were no complications associated with the translaminar screws. The mean follow-up period was 14.5 months. There was no screw breakage or displacement. Solid osseous fusion was documented in 2 patients who underwent CT scanning 15 months postoperatively. The authors found that the laminoplasty and translaminar screw technique is feasible in the thoracic and lumbar regions, but further studies are needed to analyze the biomechanical effects and long-term outcomes in a large number of patients.

Adjacent segment disease following expansive lumbar laminoplasty

Background context We developed the technique of expansive lumbar laminoplasty in 1981. In the procedure of laminoplasty, the spinal canal is decompressed by rotatory elevation of the laminae, and bone grafts from the spinous process and posterior iliac bone are placed on the surface of the operated laminae. Therefore, adjacent segment disease due to mechanical stress could be anticipated in the long-term follow-up. Purpose To investigate the incidence of symptomatic adjacent segment disease after expansive lumbar laminoplasty, to identify the factors which are related to the development of this disease, and to discuss the treatment of this postoperative problem. Study design/setting This is a retrospective cohort study. Patient sample Seventy-one patients (53 men and 18 women with a mean age of 55.7 years) underwent expansive lumbar laminoplasty for the treatment of spinal stenosis. The average length of follow-up was 5.4 years with a range of 2 to 13 years. Outcome measures Follow-up evaluation was primarily by means of clinical visits. Methods The incidence of adjacent segment disease which resulted in the deterioration of Japanese Orthopaedic Association score was analyzed. The diagnosis of symptomatic adjacent segment disease was based on both newly developed clinical symptoms and radiological lesions at the disc levels adjacent to the lumbar laminoplasty. We evaluated the correlation between the incidence of symptomatic adjacent segment disease and the clinical parameters and radiological parameters. Results Eight patients (11%) showed deterioration in the lesions at the segment adjacent to laminoplasty. The disease-free survival rates by Kaplan-Meier survival analysis were 95.7% at 5 years, 63.1% at 10 years, and 42.1% at 13 years. The incidence of spondylolisthesis in the disease group was higher than that in the disease-free group. The preoperative range of motion of L1–L5 in the disease group was significantly higher than that in the disease-free group. In five patients in whom conservative treatment failed for adjacent segment disease, reoperations were performed and they were effective. Conclusions It should be taken into account that adjacent segment disease occurs after expansive lumbar laminoplasty. Spondylolisthesis might be a risk factor for the disease. Although reoperation was effective, it is necessary to consider the patient's age and physical condition before choosing further surgical therapy.

P134. Outpatient Spinal Stenosis Decompression Using a Minimally Invasive Modified Lumbar Laminoplasty Technique: Feasibility and Early Outcomes

BACKGROUND CONTEXT: Spinal stenosis is one of the most common diseases in the elderly. The aging population has progressively greater expectations regarding mobility and maintained quality of life. The morbidity associated with traditional decompression (ie, laminectomy) particularly in the setting of degenerative spondylolisthesis has led to less destructive techniques for decompression.

腰部脊柱管狭窄症に対するきょく突起正中縦割進入法を用いた腰椎椎弓形成術の治療経験

Recently we performed lumbar laminoplasty by the midline spinous splitting approach as an operation method for lumbar spinal canal stenosis in order to preserve posterior support tissue, especially the paravertebral muscle and facet. We investigated and compared lumbar laminoplasty by the midline spinous splitting approach and conventional operation method concerning operation time and blood loss.Between October 2002 and July 2004, 21 patients underwent the conventional operation, and the number of decompression lamina was 56 levels, where 16 were male and 5 were female (mean 2.7 levels per patient). After July 2004, 13 patients underwent lumbar laminoplasty by the midline spinous splitting approach, and the number of decompression lamina was 30 levels, where 9 were male and 4 were female (mean 2.3 levels per patient). The operation time of the conventional operation method for one level was 58.3 minutes on average, and blood loss was 89.8g. That of lumbar laminoplasty by the midline spinous splitting approach for one level was 52.4 minutes on average, and blood loss was 58.3g.

Clinical and Radiographic Results of Expansive Lumbar Laminoplasty in Patients with Spinal Stenosis

In 1981, we developed a technique of expansive lumbar laminoplasty to alleviate the problems of conventional laminectomy in the treatment of spinal stenosis. The purposes of this study were to assess the long-term outcome following expansive lumbar laminoplasty and to investigate the postoperative problems. Fifty-four patients underwent expansive lumbar laminoplasty for the treatment of spinal stenosis. There were forty-three men and eleven women with a mean age of 52.6 years. The average length of follow-up was 5.5 years. Preoperatively, twenty-five patients had degenerative stenosis; thirteen, stenosis due to spondylolisthesis; twelve, combined stenosis (disc herniation and stenosis); and six, hyperostotic stenosis. (Two patients with hyperostotic stenosis and spondylolisthesis were included in both groups.) The clinical results were assessed with use of the Japanese Orthopaedic Association score, and the rate of recovery was calculated. Radiographic findings were analyzed on the basis of the cross-sectional area of the spinal canal, kyphosis, range of motion of the lumbar spine, and the rate of interlaminar fusion. The average recovery rate at the time of the last follow-up was 69.2% for patients with degenerative stenosis, 66.5% for patients with combined stenosis, 65.2% for those with hyperostotic stenosis, and 54.7% for those with spondylolisthesis. The factors resulting in a poor recovery were an older age and insufficient decompression of the lateral stenosis. During the follow-up period, the Japanese Orthopaedic Association score became worse for seven patients, six patients had lesions develop at the level adjacent to the laminoplasty, and five patients had spondylolisthesis develop. Interlaminar fusion was observed in twenty-two patients (41%). The satisfactory results of expansive lumbar laminoplasty were maintained at an average of 5.5 years after surgery. The best indications for the lumbar laminoplasty procedure were young and active patients with central spinal stenosis.