Multiple Spinal Stenosis Research Articles

A Comparative Analysis of Bi-Portal Endoscopic Spine Surgery and Unilateral Laminotomy for Bilateral Decompression in Multilevel Lumbar Stenosis Patients.

The clinical and radiological results before and after surgery were compared and analyzed for patients with multilevel lumbar stenosis who underwent bi-portal endoscopic spine surgery (BESS) and microscopic unilateral laminotomy for bilateral decompression (ULBD). We retrospectively identified 47 and 49 patients who underwent BESS and microscopic ULBD, respectively, who were diagnosed with multi-level lumbar stenosis. Clinical outcomes were evaluated using the visual analog scale score for both back and leg pain, and medication (pregabalin) use and Oswestry Disability Index (ODI) scores for overall treatment outcomes were used pre-operatively and at the final follow-up. Radiological outcomes were evaluated as the percentage of dura expansion volume, and percentage preservation of both facets and both lateral recess angles. The follow-up period of patients was about 17.04 months in the BESS group and about 16.90 months in the microscopic ULBD group. The back and leg visual analog scale (VAS) scores and average pregabalin use decreased more significantly in the BESS group than in the microscopic ULBD group (each p-value 0.0443, <0.001, 0.0378). All radiological outcomes were significantly higher in the BESS group than in the ULBD group. The change in ODI in two-level spinal stenosis showed a significantly higher value in the BESS group compared to the microscopic ULBD group (p-value 0.0335). Multilevel decompression with the BESS technique in multiple spinal stenosis is an adequate technique as it shows better clinical and radiological results than microscopic ULBD during a short-term follow-up period.

Unilateral Laminotomy for Bilateral Microsurgical Decompression in Treating Multiple Spinal Stenosis

Multiple spinal stenosis with significant signs and symptoms is one of the complex problems in spine pathology. For a simple reason, many spine surgeons do conservative decompressions, such as decompressive laminectomy or bilateral laminotomy and flavectomy, with one incision (preservation of lamina). Unilateral laminotomy in the lumbar area for bilateral access in spinal canal is quite rare and is performed for the treatment of multiple spinal stenosis.With this technique, microsurgical decompression is done with partial resection of the ipsilateral facet, the medial part of the laminar arch, and the partial contralateral facet, with the complete removal of the ligamentum flavum. By this methods, the aim for complete bilateral flavectomy and partial bilateral facetectomy are the key for the success of clinical improvements in treating multiple spinal stenosis.

Unilateral Laminotomy for Bilateral Microsurgical Decompression in Treating Multiple Spinal Stenosis

Multiple spinal stenosis with significant signs and symptoms is one of the complex problems in spine pathology. For a simple reason, many spine surgeons do conservative decompressions, such as decompressive laminectomy or bilateral laminotomy and flavectomy, with one incision (preservation of lamina). Unilateral laminotomy in the lumbar area for bilateral access in spinal canal is quite rare and is performed for the treatment of multiple spinal stenosis.With this technique, microsurgical decompression is done with partial resection of the ipsilateral facet, the medial part of the laminar arch, and the partial contralateral facet, with the complete removal of the ligamentum flavum. By this methods, the aim for complete bilateral flavectomy and partial bilateral facetectomy are the key for the success of clinical improvements in treating multiple spinal stenosis.

Unilateral Laminotomy for Bilateral Microsurgical Decompression in Treating Multiple Spinal Stenosis

Unilateral Laminotomy for Bilateral Microsurgical Decompression in Treating Multiple Spinal Stenosis

Surgical Treatment of Degenerative Lumbar Scoliosis with Multiple Spinal Stenosis

Purpose : To evaluate changes of scoliotic angle and adjacent segments after surgical treatment of degenerative lumbar scoliosis with multiple spinal stenosis. Materials and Methods : 23 patients of mutiple spinal stenosis with more than 10 degree of scoliotic angle were retrospectively reviewed from March, 1997 to May, 2001. All patients underwent wide total laminectomy & instrumentation by fixation of pedicle screw and autogenous bone graft. And their average of follow up period was 21 months. Lordotic and scoliotic angle was measured with Cobb’s method by using simple X-ray. And degenerative scoliosis was analyzed by Simmons’ Classification. Results : Fusion was performed in 3.1 segments and wide total laminectomy was performed in 2.6 segments. And in type I of Simmons’ classification degenerative scoliosis found in 15 cases, and 8 cases in type II. After the surgical correction scoliotic angle was decreased from 14 to 8 degrees, and the lordotic angle increased from 14 to 19 degrees. And no significant changes was found in the last follow up. 16 cases (70%) showed the “excellent” and “good” clinical results and Simmons type II showed better clinical results than those of type I (type I was 9 cases and type II was 7 cases). Conclusion : Patients with degenerative lumbar scoliosis with multiple spinal stenosis treated with wide total laminectomy and instrumentation by fixation of pedicle screw showed effects in coronal and sagittal balance, and considering instability resulting from involvements in multiple segments and other complex pathologic conditions seems to be important.