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

Kawaguchi, Yoshiharu; Koike, Masahiko; Ishihara, Hirokazu; Kikkawa, Tasuku; Matsui, Hisao; Tsuji, Haruo; Kimura, Takeshi

doi:10.2106/jbjs.e.00211

Cited by 16 publications

(8 citation statements)

References 4 publications

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“…The etiology of constriction in the majority of the cases of LSS stem from degenerative ligamentum flavum hypertrophy (46%), listhesis with or without ligamentum flavum hypertrophy (24%), disc with or without ligamentum flavum hypertrophy (22%), and hyperostotic changes (11%). 4 Conventional surgical therapy has relied on laminectomy for LSS decompression, however, there have been reports of high complication rates. Benz et al 5 reported a 40% complication rate in a series of patients 70 years of age or older who underwent lumbar decompression.…”

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confidence: 99%

mild Interlaminar Decompression for the Treatment of Lumbar Spinal Stenosis

Wong

2012

The Clinical Journal of Pain

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The mild technique provides an attractive early option for the treatment of symptomatic lumbar spinal stenosis after failed injection therapy, but before more invasive surgical treatment. For 17 patients with 1-year follow-up, the mild procedure provided significant pain relief and increased mobility. This procedure leaves no implants behind, and therefore does not limit subsequent, more invasive procedures that require implants.

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confidence: 99%

mild Interlaminar Decompression for the Treatment of Lumbar Spinal Stenosis

Wong

2012

The Clinical Journal of Pain

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“…[ 14 15 16 ] In laminoplasty, the dura is covered by the bone; thus, restrangulation by the postlaminectomy membrane does not occur. [ 18 28 29 ] But laminoplasty does not have good results in aged >65 years, myelopathy of >2 year duration, spinal canal stenosis of >60%, and kyphotic cervical spine curvature. [ 17 18 ]…”

Section: Discussionmentioning

confidence: 99%

“…Our technique increased the diameter of spinal canal which enhances neurological recovery because of canal enlargement and improvement in the circulation of the spinal cord and nerve roots. [ 18 28 29 ] The re-stenosis of the spinal canal is supposed to be the most common complication of our technique, but the authors did not encounter it in any patients till date; however, long-term results are still awaited. Other complications reported in the literature, like transient C5-6 root paresis, severe neck pain with or without paresthesias, and under riding of the lamina at the hinged side had not occurred in any of our patients.…”

Section: Discussionmentioning

confidence: 99%

Our technique of midsagittal splitting laminoplasty for compressive cervical myelopathy and its short-term results

et al. 2016

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Objective:The aim of this study was to discuss the technique of midsagittal splitting laminoplasty and to compare its short-term follow-up results with laminectomy in cases of compressive cervical spinal cord myelopathy.Materials and Methods:Exclusion criteria were as follows: Intramedullary compressive lesions, kyphotic cervical spine, previous spinal surgeries, and defective anterior vertebral column. Twenty patients (10 each of laminoplasty and laminectomy groups) were prospectively studied from 2005 to 2008. After clinico-radiological assessment, laminoplasty or laminectomy was performed in patients aged <50 years and >50 years, respectively. The laminoplasty was performed by splitting the excised lamina in midline up to the tip of spinous process. Follow-up was done by neurosurgical cervical spine scoring, Nurick's grading, and the final outcome was determined by Odom's criteria.Results:The mean operative time and blood loss in laminoplasty and laminectomy was 100 ± 0.87 (range 90-140 min), 80 ± 0.67 (range 75-100 min) P = 0.04; and 65 ± 0.07 (range 60-90 ml) and 68 ± 0.61 (range 65-80 ml) P = 0.09, respectively. There were no intraoperative accidents, and no postoperative neurological deterioration/recurrence of symptoms. One patient who underwent laminectomy alone developed progressive kyphosis of the spine, whereas one having rheumatoid arthritis and long symptom duration didn’t improve. 85% (17/20 patients) had sustained excellent to fair outcome (improvement by at least one Nurick's grade).Conclusions:The technique used by us was simple, effective, and inexpensive. There was no minimal postoperative morbidity, although long-term results are awaited.

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“…The laminectomy is always a standard approach to treat lumbar degenerative disease, but it can damage the posterior structure of lumbar, affect spinal stability, cause backache due to the postoperative scar adhesions, and cause failed back surgery syndrome. According to the clinical follow-up implemented by Kawaguchi et al [10], 10% of patients had spondylolysis. The study of Sen et al [11] suggested that the incidence of failed back surgery syndrome caused by epidural scar adhesion was 8–24%.…”

Section: Discussionmentioning

confidence: 99%

Early clinical effects of the Dynesys system plus transfacet decompression through the Wiltse approach for the treatment of lumbar degenerative diseases

Tian

2014

Med Sci Monit

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BackgroundThis study investigated early clinical effects of Dynesys system plus transfacet decompression through the Wiltse approach in treating lumbar degenerative diseases.Material/Methods37 patients with lumbar degenerative disease were treated with the Dynesys system plus transfacet decompression through the Wiltse approach.ResultsResults showed that all patients healed from surgery without severe complications. The average follow-up time was 20 months (9–36 months). Visual Analogue Scale and Oswestry Disability Index scores decreased significantly after surgery and at the final follow-up. There was a significant difference in the height of the intervertebral space and intervertebral range of motion (ROM) at the stabilized segment, but no significant changes were seen at the adjacent segments. X-ray scans showed no instability, internal fixation loosening, breakage, or distortion in the follow-up.ConclusionsThe Dynesys system plus transfacet decompression through the Wiltse approach is a therapeutic option for mild lumbar degenerative disease. This method can retain the structure of the lumbar posterior complex and the motion of the fixed segment, reduce the incidence of low back pain, and decompress the nerve root.

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

Abstract: 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.

Cited by 16 publications

References 4 publications

mild Interlaminar Decompression for the Treatment of Lumbar Spinal Stenosis

mild Interlaminar Decompression for the Treatment of Lumbar Spinal Stenosis

Our technique of midsagittal splitting laminoplasty for compressive cervical myelopathy and its short-term results

Early clinical effects of the Dynesys system plus transfacet decompression through the Wiltse approach for the treatment of lumbar degenerative diseases

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