Total Laminectomy Research Articles

SPINAL INSTABILITY FOLLOWING SURGERY FOR DEGENERATIVE LUMBAR STENOSIS

Background: Recognition that total laminectomy may perpetuate or cause segmental instability heralded the introduction of less invasive techniques of decompression in lumbar spinal stenosis surgery. Aim : It was our aim to compare formal laminectomy and minimally invasive decompressive procedures in terms of safety and clinical outcome, specifically in respect to the development of postoperative spinal instability. Methods: A retrospective analysis of medical records for 73 patients operated on for lumbar spinal stenosis (22 patients after laminectomy and 51 patients after minimally invasive decompression), with available follow-up data was performed. Basic variables were analyzed in respect to clinical outcome and in regard to development of radiological instability. Results: Radiologic instability was present in 27,3% of patients after laminectomy, as compared to only 2,0% after laminotomy (p<0,001). Regression analysis identified presence of preoperative slip (p=0,0056) and type of surgery (p=0,0204) as sole predictors of instability after surgery. Clinical outcome analysis (laminectomy vs. laminotomy) revealed favorable outcome in both treatment groups, although significantly in favor of the laminotomy group (VAS p= 0,013 and RM p=0,031). Finally, difference in outcome was affected by weather radiologic instability was present or not (p=0,04 and p=0,09 for difference in outcome graded by VAS and RM values respectively) Conclusion: Our results suggest that laminectomy is associated with prohibitively high incidence of postoperative radiologic instability when compared to minimally invasive decompression techniques. Furthermore, radiological instability translates to worse clinical outcome. Finally, patients undergoing laminectomy experience less favorable clinical outcome when compared to those undergoing minimally invasive decompression surgeries.

Large thoracolumbar extradural arachnoid cyst excised by minimal skipped hemilaminectomy: a case report.

The standard treatment for symptomatic spinal extradural arachnoid cyst (SEAC) is complete surgical removal of cyst and closure of the dural defect. In most cases, total laminectomy has been performed at affected vertebra for complete removal of the SEAC. However, this invasive surgery may result in postoperative kyphosis and back pain. We report a case of large SEAC involving T10-L1 which was excised through the minimal skipped hemilaminectomy, to minimize the risk of postoperative kyphotic deformity. Simultaneously, we closed the dural defect after preoperative precise identification of the site through several radiological studies.

Pneumomediastinum, Subcutaneous Emphysema, and Tracheal Tear in the Early Postoperative Period of Spinal Surgery in a Paraplegic Achondroplastic Dwarf

Achondroplasia was first described in 1878 and is the most common form of human skeletal dysplasia. Spinal manifestations include thoracolumbar kyphosis, foramen magnum, and spinal stenosis. Progressive kyphosis can result in spinal cord compression and paraplegia due to the reduced size of spinal canal. The deficits are typically progressive, presenting as an insidious onset of paresthesia, followed by the inability to walk and then by urinary incontinence. Paraplegia can be the result of direct pressure on the cord by bone or the injury to the anterior spinal vessels by a protruding bone. Surgical treatment consists of posterior instrumentation, fusion with total wide laminectomy at stenosis levels, and anterior interbody support. Pedicle screws are preferred for spinal instrumentation because wires and hooks may induce spinal cord injury due to the narrow spinal canal. Pedicle lengths are significantly shorter, and 20–25 mm long screws are appropriate for lower thoracic and lumbar pedicles in adult achondroplastic There is no information about the appropriate length of screws for the upper thoracic pedicles. Tracheal injury due to inappropriate pedicle screw length is a rare complication. We report an extremely rare case of tracheal tear due to posterior instrumentation and its management in the early postoperative period.

A Dumbbell-shaped Meningioma in the Thoracic Spine: A Case Report

Background Context: Thoracic involvements of meningiomas are rarely seen and only a couple of dumbbellshaped meningiomas are reported in the literature. Spinal meningiomas (SM) consist of 25% of all spinal masses. Most of the SMs are intradural. Less than 10% have extradural extension. Purpose: Pure spinal extradural meningiomas (SEM) are seen so rare. We are reporting the 7th case of meningioma with dumbbell-appearance located in the cervicothoracal region. Methods: 48 years old female patient who has no known disease before she has referred to our clinic with complaints of pain, feeling of numbness at the right arm, shoulder and the back that she has been suffering for 6 months. In the neurological examination of the patient, hypoesthesia has seen under the level of Th1. Deep tendon reflexes of the lower extremities (DTR) were observed to be suspicious bilaterally in respect to hyperactivity. In the spinal magnetic resonance imaging (MRI) of the patient), after Gadolinium infusion of the mass involving the epidural area in the spinal channel of the bone between C7 vertebra and T2 vertebrae, resulting in dumbbell appearance, a lesion with homogenous contrast enhancement was observed. Results: T1 total laminectomy was applied to the patient. The mass found in the extradural region and extending to the apex of the right lung was totally removed with micro chirurgical method. Pathology of the mass was reported as psammomatous meningioma. The patient was discharged at the post-operative 3rd day without an additional neurologic deficit. Conclusion: Though extradural spinal meningiomas are rarely seen, since they imitate spinal metastatic masses, should be kept in mind in the differential diagnosis. Surgery should be the first treatment of choice.

The Correlation Study of C5 Nerve Root Palsy and Common Body Position in Posterior Total Laminectomy Decompression and Instrumentation.

To compare both the clinical characteristics and incidence of postoperative cervical nerve root palsy in cervical spondylosis patients treated by posterior total laminectomy, decompression and instrumentation with two different common body positions, traction bed and plaster bed. One hundred and thirty-three patients, with a mean age of 49.5 years suffering from multilevel cervical spondylosis and treated by laminectomy from 2007 to 2009, were reviewed. Overall 30 of 133 (22.56%) patients had C5 palsy, of which 14 (19.44%) out of 72 patients were in the plaster bed group, while 16 of 61 (26.23%) patients were in the traction bed group. The difference was statistically significant (P < 0.05). The cervical curvature index (CCI) reflected both the change of cervical height and the change of the overall cervical curvature. CCI was related with the incidence of C5 nerve root palsy postoperatively. The patients in the traction bed group had a higher nerve root palsy rate and change in cervical alignment because of over traction.

Acute spontaneous cervical epidural hematoma mimicking cerebral stroke: a case report and literature review.

Spontaneous cervical epidural hematoma (SCEDH) is a rare disease, but can cause severe neurologic impairment. We report a case of a 68-year-old female who presented with sudden onset, posterior neck pain, right shoulder pain, and progressive right hemiparesis mimicking stroke with no trauma history. Initial brain CT and diffusion MRI performed to rule out brain lesion did not show any positive findings. Laboratory examination presented only severe thrombocytopenia (45,000/mm3). Subsequent cervical MRI revealed a cervical epidural mass lesion. We confirmed that it was pure hematoma through C5 unilateral total laminectomy and C6 partial hemilaminectomy. She achieved complete neurologic recovery with active rehabilitation. Early surgical decompression for SCEDH with neurologic impairment should be recommended for better outcome.

Hyperbaric oxygen in epidural fibrosis: is there a potential for treatment?

To investigate the effects of hyperbaric oxygen treatment on epidural fibrosis formation in an experimental laminectomy model. Twenty-four Wistar rats underwent L5-L6 total laminectomy and divided into three groups. Animals in the control group received no further treatment while animals in short and long term groups received 2,5 ATM ABS of hyperbaric oxygen for 3 and 7 days, respectively. The amount of epidural fibrosis was analyzed histologically at the end of 42 days of follow up. The ratio of severe fibrosis was 57% in the control, 29% in the short HBOT, and 14% in the long HBOT groups. Although there was a clear trend towards having less fibrosis in the HBOT groups, the difference did not reach to the level of statistical significance (p=0.242), probably due to small number of animals used in this preliminary study. Our findings suggest that hyperbaric oxygen treatment may have favorable effects on epidural fibrosis. Further studies with larger cohorts are required to prove our results.

Investigation of Efficacy of Mitomycin-C, Sodium Hyaluronate and Human Amniotic Fluid in Preventing Epidural Fibrosis and Adhesion Using a Rat Laminectomy Model

Study DesignA retrospective study.PurposeThe aim of this study was to evalute the effects of mitomycin-C, sodium hyaluronate and human amniotic fluid on preventing spinal epidural fibrosis.Overview of LiteratureThe role of scar tissue in pain formation is not exactly known, but it is reported that scar tissue causes adhesions between anatomic structures. Intensive fibrotic tissue compresses on anatomic structures and increases the sensitivity of the nerve root for recurrent herniation and lateral spinal stenosis via limiting movements of the root. Also, neuronal atrophy and axonal degeneration occur under scar tissue.MethodsThe study design included 4 groups of rats: group 1 was the control group, groups 2, 3, and 4 receieved antifibrotic agents, mitomycin-C (group 2), sodium hyaluronate (group 3), and human amniotic fluid (group 4). Midline incision for all animals were done on L5 for total laminectomy. Four weeks after the surgery, the rats were sacrificed and specimens were stained with hematoxylin-eosin and photos of the slides were taken for quantitive assesment of the scar tissue.ResultsThere was no significant scar tissue in the experimental animals of groups 2, 3, and 4. It was found that there was no significant difference between drug groups, but there was a statistically significant difference between the drug groups and the control group.ConclusionsThis experimental study shows that implantation of mitomycin-C, sodium hyaluronate and human amniotic fluid reduces epidural fibrosis and adhesions after spinal laminectomy in rat models. Further studies in humans are needed to determine the complications of the agents researched.

Acute cerebellar ischemia after lumbar spinal surgery: a rare clinical entity

To the Editor: We present a case of cerebellar ischemia following a lumbar spinal surgery with prolonged prone position. Acute cerebellar ischemia after lumbar surgery is extremely rare, and its exact cause is not well known [1, 2]. Compression of vertebral arteries as a result of the prone position and unusual neck rotation with prolonged surgery have been demonstrated as the causes of cerebellar hypoperfusion leading to ischemia [2, 3]. Our patient was an ASA physical status II, 69-year-old man with degenerative lumbar stenosis at L2–L3–L4 levels. The patient had small ischemic areas on his previous cranial magnetic resonance imaging (MRI), and a left vertebral artery occlusion was detected on his previous computed tomography (CT) angiography performed 2 years ago; with no neurological symptoms or signs relevant to those lesions. Clopidogrel and acetyl salicylic acid administered previously were discontinued 7 days before the operation to avoid the risk of intraoperative bleeding. Compression stockings were applied to the patient to prevent the thromboembolic events of both cardiovascular and central nervous system. The patient was turned into prone position with his head semiflexed and mildly turned to his right side on a donut cushion, not exceeding his normal range of motion. Neutral position could not be achieved because of his short neck. Parallel chest foams were placed because of lack of a spine frame. Total laminectomy and fusion by transpedicular screw stabilization was performed at L2 to L5 levels, and the duration of the operation was 6 h. Throughout the surgery, mean arterial pressure was kept at 65–70 mmHg levels for the majority of the operation. The patient had altering levels of consciousness, dysarthria, and dizziness 2 h after the surgery. Brain CT scan demonstrated an acute cerebellar ischemia with surrounding edema in both hemispheres, more marked on the left side (Fig. 1). The patient was discharged from the hospital 4 weeks later with satisfying recovery of consciousness and dizziness, although his dysarthria improved very slowly. The position of our patient might have compromised the blood flow of right vertebral artery. Also, our patient had a prior left vertebral arterial occlusion. Both the position and the prior left vertebral arterial occlusion might have contributed to the ischemia involving both sides of the cerebellum. Our preventive measures were the application of compression stockings and avoiding hypotension and extensive neck rotation. Additionally, a low molecular heparin prophylaxis could have been considered to prevent possible contribution of thromboembolic complication. Further, aspirin should have not been discontinued, as suggested in a most recent review [4]. We conclude that preference of neutral alignment of the neck, maintenance of mean arterial pressure in normal range, and F. Harman M. Yaman E. Kaptanoglu Department of Neurosurgery, Near East University Faculty of Medicine, Lefkosa, Mersin 10, Turkey

Spinal subarachnoid hematoma in a woman with HELLP syndrome: a case report

IntroductionSubarachnoid hemorrhages of spinal origin are extremely rare during pregnancy. We present the case of a patient with hemolytic anemia, elevated liver enzymes and low platelet count (the so-called HELLP syndrome), a potentially life-threatening complication associated with pre-eclampsia, who presented with an idiopathic spinal subarachnoid hematoma.Case presentationAt 29 gestational weeks, a 35-year-old Japanese woman was diagnosed with HELLP syndrome based on bilateral leg paralysis, diminished sensation and reflexes, and laboratory findings. The pregnancy was immediately brought to an end by Cesarean delivery. Post-operatively, an MRI scan revealed a space-occupying lesion in her thoracic spinal canal. Emergency decompression was followed by total laminectomy. A subarachnoid hematoma, partially extending as far as the ventral side, was removed. After thorough washing and drain placement, the operation was completed with the suturing of artificial dura mater. Eight months post-operatively, her lower extremity sensation had improved to a score of 8 out of 10, but improvements in her muscular strength were limited to slight gains in her toes. MRI scans taken two months post-operatively revealed edematous spinal cord changes within her medulla.ConclusionsA subarachnoid hematoma during pregnancy is extremely rare, possibly due to increased coagulability during pregnancy. However, this complication is potentially devastating should a clot compress the spinal cord or cauda equina. While several causes of hematoma have been proposed, we speculate that the factors underlying hemorrhagic diathesis in our case were the decreased platelet count characteristic of HELLP syndrome and vascular fragility due to elevated estrogen levels, in addition to increased abdominal pressure during pregnancy and pressure from the gravid uterus resulting in ruptured vessels around the spinal cord. In cases displaying a progressive lesion and severe neurological signs, prompt decompression is crucial.

Asymptomatic thoracic Pantopaque cyst mimicking an intradural extramedullary lipoma on MR images

Oil-based contrast media such as Pantopaque have not used for imaging for several decades, but because these contrast media have an extremely low clearance rate, the remnant contrast media or residual sequelae of these materials may be encountered in the clinical field. A 63-year-old woman presented to our hospital complaining of increasing lower back pain and lower extremity paresthesia with incontinence for 2 years. A plain X-ray film revealed single droplet-like mass at the lower thoracic T9-T10. A magnetic resonance image (MRI) study revealed a dorsally placed extramedullary intradural lesion, compressing the thoracic cord and minimally displacing it anteriorly. Spinal stenosis was also noted at the L4-5 level. The patient was performed for two consecutive surgeries. Total laminectomy was performed at T9-T10 to remove mass. A 0.5 × 0.5 × 4 cm yellowish intradural extramedullary cystic mass was removed without any leakage of cystic contents. Partial hemi-laminectomy and foraminotomy was then done at L4-5 levels for radiculopathy symptom relief. The fluid from the cyst was composed mainly of iodide. Intraspinal masses showing metal-like density in X-ray or computed tomography but in MRI showing only lipoma or cystic lesions, not metallic characteristics, the differential diagnosis should include iophendylate (Pantopaque) cyst. Oil-based contrast medium is believed to have the potential to make a syrinx formation via arachnoiditis, which can lead to severe neurologic deteriorations, so even if the patients do not represent with an acute neurologic deficit, surgical total removal of remnant material without leaking should be considered.

Anatomical study of the cervical nerve roots for posterior foraminotomy: cadaveric study

Anatomical study of the relationship among the cervical nerve roots, intervertebral disc, and lateral mass is important for the neurosurgeon to avoid complications of posterior cervical foraminotomy. Six adult cadavers were studied. The muscles of the back of the neck were removed to expose the cervical vertebrae posteriorly from C3 to C7. We measured the length, height, extent, and angulations of the nerve roots from the medial point of the facet (MPF) after a total laminectomy, then after one-half facetectomy. The height, width, anteroposterior diameter of the lateral mass, then the height and anteroposterior diameter of the neural foramen were also measured. After total laminectomy from C3 to C7, all measures were taken from MPF showed that the mean length of the exposed root was 6.5-8.8mm while vertical distance was 4-5.4mm and the horizontal distance was 5.1-7.1mm. Following a medial one-half facetectomy; the mean length of the exposed root was 8.9-12.3mm, the vertical distance was 5.5-7.3mm while the horizontal distance was 7.1-9.8mm. The mean angulations of the nerve roots were 50.9-53.3º. There was a significant difference after total laminectomy and medial one-half facetectomy. Anatomic and morphologic study of the cervical nerve roots and their relationships to the lateral mass and the intervertebral disc are useful landmarks to reduce the operative complications of the posterior foraminotomy.

Minimally Invasive Removal of an Intradural Cervical Tumor : Assessment of a Combined Split-Spinous Laminectomy and Quadrant Tube Retractor System Technique

Conventional laminectomy is the most popular technique for the complete removal of intradural spinal tumors. In particular, the central portion intramedullary tumor and large intradural extramedullary tumor often require a total laminectomy for the midline myelotomy, sufficient decompression, and adequate visualization. However, this technique has the disadvantages of a wide incision, extensive periosteal muscle dissection, and bony structural injury. Recently, split-spinous laminectomy and tubular retractor systems were found to decrease postoperative muscle injuries, skin incision size and discomfort. The combined technique of split-spinous laminectomy, using a quadrant tube retractor system allows for an excellent exposure of the tumor with minimal trauma of the surrounding tissue. We propose that this technique offers possible advantages over the traditional open tumor removal of the intradural spinal cord tumors, which covers one or two cervical levels and requires a total laminectomy.

Intraoperative Vertebral Artery Angiography to Guide C1-2 Transarticular Screw Fixation in a Patient with Athetoid Cerebral Palsy

We present a case of an athetoid cerebral palsy with quadriparesis caused by kyphotic deformity of the cervical spine, severe spinal stenosis at the cervicomedullary junction, and atlantoaxial instability. The patient improved after the first surgery, which included a C1 total laminectomy and C-arm guided righ side unilateral C1-2 transarticular screw fixation. C1-2 fixation was not performed on the other side because of an aberrant and dominant vertebral artery (VA). Eight months after the first operation, the patient required revision surgery for persistent neck pain and screw malposition. We used intraoperative VA angiography with simultaneous fluoroscopy for precise image guidance during bilateral C1-2 transarticular screw fixation. Intraoperative VA angiography allowed the accurate insertion of screws, and can therefore be used to avoid VA injury during C1-2 transarticular screw fixation in comorbid patients with atlantoaxial deformities.

Surgical management of symptomatic t8 vertebral hemangioma: case report and review of the literature

Vertebral hemangiomas are benign vascular lesions of the vertebral column; only 0.9-1.2% of all vertebral hemangiomas cause spinal cord compression. We report a 34-year-old female who was admitted to the neurosurgery clinic with a history of back pain, poor quality of life and easy fatigability for 1.5 years. Her medical history revealed a fall from a height of 2 meters 1.5 years ago. Neurology examination revealed bilateral hypoesthesia below the T8 level and hyperactive deep tendon reflexes in her left leg. Computed tomography scan of the thoracic spine showed T8 vertebral hemangioma, and magnetic resonance imaging showed a T8 hemangioma compressing the spinal cord. Surgical intervention was planned and T8 total laminectomy was performed. The tumor extending into the anterior spinal cord was resected, and T8 vertebroplasty with short segment posterior stabilization and fusion was performed. We aimed to present a new treatment approach for symptomatic vertebral hemangiomas and reviewed the relevant literature.

Extended Fenestration Surgery in Degenerative Lumbar Canal Stenosis

Therapy for degenerative lumbar spinal canal stenosis remains difficult. Decompression by total laminectomy is the treatment of choice for central canal stenosis in the lumbar region. It is critical that sufficient bone is removed to free the nerve roots, but the extent of decompression should be as small as possible, in order to prevent postoperative instability. However, too limited a decompression can be accompanied by re-growth of bone that affects the long term results. Also total laminectomy at multiple levels may result in instability of the spine.

Comparative Preventive Efficacy of Recombinant Tissue Plasminogen Activator (rt-PA), Urokinase, Hyaluronic acid and Enoxaparin in Post Laminectomy Epidural Fibrosis in Rats

Aim: We aimed to determine the effects of rt-PA and enoxaparin on post laminectomy epidural fibrosis and to compare the effects of these two medications with hyaluronic acid and urokinase in an experimental model of spinal epidural fibrosis. Method: Forty Spraque-Dawley rats were anaesthetized by intraperitoneal anesthesia (ketamin 8 mg/100 g) and randomly allocated to five groups. All groups were underwent L1-2 total laminectomies. Topical medications were applied to group 2-5 right after the laminectomy space. Hence, in group 1 (G1=control) only laminectomy was constituted, in group 2 (G2) laminectomy + topical Urokinase, in group 3 (G3) laminectomy + topical rt-PA, in group 4 (G4) laminectomy + topical enoxaparin and in group 5 laminectomy + topical Hyaluronic acid (G5) application were performed. The potentials of local urokinase, rt-PA, hyaluronic acid and enoxaparin in preventing the production of epidural fibrosis were assessed. Result: In inter group comparison, G1-G2, G1-G3, G1-G4, G1-G5 groups differed from each other for total scar score, middle scar score and deep scar score (p<0.05). However, G2-G3, G2-G4, G2-G5, G3-G4, G3-G5 and G4-G5 were not different from each other. Conclusion: In rats, the topical thrombolysis with fibrinolitic agents is safe and efficacious in preventing of post laminectomy epidural fibrosis. Thrombolytic therapy with topical hyaluronic acid, rt-PA, urokinase and enoxaparin may come to play an important role in the prevention of post operative spinal epidural fibrosis and arachnoiditis. Based on the results we found that rt-PA and enoxaparine inhibit the formation of epidural scar adhesions and arachnoiditis compared with control group.

Lumbar Ligamentum Flavum Hematoma Treated With Endoscopy

Hematoma of the ligamentum flavum is a rare cause of neural compression, for which treatment has consisted of excising the hematoma via open surgical approaches, including total laminectomy or bilateral partial laminectomy. This article presents the first report of a microscope-assisted endoscopic decompression to resect a hematoma of the ligamentum flavum.A 52-year-old man presented with back and leg pain, as well as difficulty initiating micturation. Magnetic resonance imaging demonstrated an epidural mass at L5/S1 that was continuous with the facet joint. Visualization was obtained via an endoscope, and a reddish tan-brown solid mass was found beneath the ligamentum flavum. Thorough decompression of the cauda equine and nerve roots was undertaken. The patient's radicular leg pain and bladder function improved soon after the decompression. Histological examination of the ligamentum flavum revealed a consolidated hematoma with granulomatous change.A review of the English literature revealed 29 cases of hematoma in the lumbar ligamentum flavum. Surgical decompression in these patients was accomplished with a standard open approach through hemilaminectomy (n=11), total laminectomy (n=10), or laminectomy followed by posterior fixation (n=3). The literature review did not identify any case of hematoma of the lumbar ligamentum flavum that was treated endoscopically. We expect our case may expand the indications for the endoscope in spine surgery.

Case report on the development of a brucellosis-related epidural abscess

Brucellosis is an endemic disease in developing countries. The most commonly observed complications include bone-joint involvement, particularly sacroiliitis and spondylitis. Epidural abscesses caused by brucellosis are a rare complication. We describe the case of a 33-year-old man presenting with high fever, back pain, and weakness. At physical examination, the patient was found to be paraparetic. At thoracic MRI, spondylodiscitis and epidural abscess with significant cord compression were observed. In laboratory examinations, Rose Bengal and tube agglutination tests were positive in patient's serum for brucellosis, and specific antibiotherapy was initiated. Total laminectomy was performed and the abscess was aspirated. The biopsy sample was consistent with chronic non-specific inflammation in acute abscess. No growth was detected in the abscess or blood cultures. Following surgery, medical treatment was initiated and, at six weeks' follow-up, clinical and MRI findings indicated that he had recovered. The diagnosis of spinal epidural abscess due to brucellosis should be considered among differential diagnoses in endemic regions. Early diagnosis and specific treatment are important to prevent later complications.

Adjacent Segment Degeneration after Single-Level PLIF: Comparison between Spondylolytic Spondylolisthesis, Degenerative Spondylolisthesis and Spinal Stenosis

Study DesignA retrospective study.PurposeTo comparatively investigated the rate of the adjacent segment degeneration and the clinical outcomes in patients with spondylolytic spondylolisthesis, spinal stenosis or degenerative spondylolisthesis.Overview of LiteratureThere have been few studies reported on the adjacent segment degeneration following posterior lumbar interbody fusion(PLIF). Many risk factors for the adjacent segment degeneration following PLIF have been proposed. The range of decompression has been presented as one of the risk factors, yet controversial.MethodsThis study enrolled sixty-three patients who had been treated with single-level PLIF and who were followed up for more than two years. The patients were divided into 3 groups based on the preoperative diagnosis. We analyzed the difference between the preoperative and postoperative intervertebral disc heights of the superior adjacent segments. The incidence rates of instability and the clinical outcomes were comparatively analyzed between each group.ResultsThe average age of the patients was 55.8 years in the spondylolytic spondylolisthesis group, 65.9 years in the degenerative spondylolisthesis group and 60.4 years in the spinal stenosis group. The average follow-up period was 44 months, 43 months and 42 months, respectively. At the last follow-up, compared to the preoperative period, the intervertebral disc height decreased in all three groups. A statistically significant decrease (p < 0.01) was observed only in the spondylolytic spondylolisthesis group and no significant difference was observed between each group (p = 0.41). The incidence rate of instability and the clinical outcome were not significantly different between each group.ConclusionsSpondylolytic spondylolisthesis with total laminectomy and single-level PLIF showed no significant difference in the superior adjacent segment degeneration and instability, and the clinical outcome as compared to that of partial laminectomy with single-level PLIF for treating degenerative spondylolisthesis or spinal stenosis.