Microscopic Laminotomies for Degenerative Lumbar Spinal Stenosis

Tsai, Richard Yen-chun; Yang, Rong‐Sen; Bray, R. S.

doi:10.1097/00002517-199810000-00004

Cited by 72 publications

(57 citation statements)

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“…These numbers are higher than the success rates for laminectomy, which vary in the current literature between 50% and 70% 12,25,27,30,45,58,60 with satisfaction rates between 55% and 73%, 6,7,29,58,63 but are similar to the results of unilateral laminotomy studies (successful results in more than 80% of patients, and satisfaction rates ranging from 74.4% to 97%) 40,55,58,62 and bilateral series (good results reported in 68% to 90% of cases). 4,34,42,57,59,64 Interestingly, we did find a difference in patient satisfaction, as significantly more patients in the unilateral group were satisfied overall in comparison with the bilaterally operated patients (82.1% vs 69.1%, p = 0.047). This is in contrast to results reported by Thomé et al who investigated almost identical techniques (except they also preserved the supra-and interspinous ligaments while using the bilateral technique).…”

Section: Patient Satisfaction and General Evaluationsmentioning

confidence: 64%

“…Both the bilateral interlaminar approach for bilateral decompression, 4,22,43,46,58,59,64 as well as the unilateral ap proach, 11,14,22,26,40,41,43,51,55,62 have been extensively researched and have shown promising results. Most of these studies, however, were limited by the size of the study population and choice of intervention.…”

Section: Discussionmentioning

confidence: 99%

“…These less invasive lumbar microsurgical decompressive techniques have shown good clinical results and, at the same time, have reduced the chance of postoperative instability. 9,22,34,42,43,46,58,59,62,64 However, whether or not these two techniques are equal to each other in terms of important postoperative clinical outcomes and certain surgical parameters remains unclear. A large, preferably prospective, randomized study that compares only these two techniques is lacking; however, one needs to be critical when questioning the real benefits of such a study if both treatment options demonstrate similar and promising results.…”

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confidence: 99%

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Bilateral versus unilateral interlaminar approach for bilateral decompression in patients with single-level degenerative lumbar spinal stenosis: a multicenter retrospective study of 175 patients on postoperative pain, functional disability, and patient satisfaction

Boogert

Keers²,

Oterdoom

et al. 2015

SPI

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OBJECT The bilateral and unilateral interlaminar techniques for bilateral decompression both demonstrate good results for the treatment of degenerative lumbar spinal stenosis (DLSS). Although there is some discussion about which approach is more effective, studies that directly compare these two popular techniques are rare. To address this shortcoming, this study compares postoperative functional disability, pain, and patient satisfaction among patients with single-level DLSS who underwent bilateral decompression using either a bilateral or unilateral approach. METHODS This retrospective study included patients who underwent operations between November 1, 2009, and October 1, 2011. These patients underwent single-level bilateral decompressive surgery using either the bilateral or unilateral interlaminar approach at one of 5 participating hospitals. Exclusion criteria included previous lumbar surgery, additional disc surgery, and spondylolisthesis requiring fusion surgery. Primary outcome measures included bodily pain (as reported using the visual analog scale [VAS]), the Roland-Morris Disability Questionnaire (RMDQ), and the Oswestry Disability Index (ODI). In addition, reductions in leg and back symptoms and the patient’s general evaluation of the procedure were queried. Finally, patient satisfaction and surgical parameters were evaluated. Questionnaires were sent to each patient’s home, and electronic patient files were used to collect the data. RESULTS One hundred and seventy-five patients returned the questionnaire (74.4% response rate; 68 and 107 patients who underwent the bilateral or unilateral approach, respectively). Mean age at surgery was 68 years (range 34–89 years), and the mean follow-up period was 14.2 months (range 3.3–27.4 years). There were no significant differences in ODI (20.3 vs 22.6 for the bilateral and unilateral approaches, respectively), RMDQ (3.99 vs 4.8, respectively), or pain scores between treatment groups. Back symptoms were reduced in 74.8% (bilateral: 74.6% vs unilateral: 75%; not significant), and leg symptoms in 80.6% of the patients (bilateral: 73.1% vs unilateral: 85.4%; p = 0.048). In total, 72.1% (bilateral) and 80.0% (unilateral) of patients reported good overall treatment results (p = 0.226). Significantly more patients in the unilateral group reported a better overall satisfaction with the procedure (82.1% vs 69.1%; p = 0.047). CONCLUSIONS There were no differences in postoperative functional disability and pain between the surgical techniques. The significant differences in patient satisfaction and reduction in leg symptoms were unrelated to surgical technique. The overall treatment results were satisfactory. Both techniques are safe and effective options for treating patients with single-level DLSS.

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Section: Patient Satisfaction and General Evaluationsmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Bilateral versus unilateral interlaminar approach for bilateral decompression in patients with single-level degenerative lumbar spinal stenosis: a multicenter retrospective study of 175 patients on postoperative pain, functional disability, and patient satisfaction

Boogert

Keers²,

Oterdoom

et al. 2015

SPI

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“…There is a growing body of evidence that 60-80% of the population experience chronic low back pain [17,18]. Undoubtedly, back pain-related ailments effect in longterm or recurrent disability [17,18].…”

Section: Discussionmentioning

confidence: 99%

Quality of life and sociodemographic data in patients after spine surgery

2012

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“…Damage to the "tension band" consisting of the supra-and interspinous ligaments may lead to increased instability with lumbar flexion. 18,19 "Failed back syndrome" and intractable pain may thus follow. 15,16 Wide decompressions that destabilize the facet complexes have been associated with worse outcomes.…”

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confidence: 99%

Minimally invasive decompression for lumbar stenosis and disc herniation

Armin

Holly²,

Khoo³

2008

FOC

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For decades, lumbar disc herniation and lumbar stenosis have been treated surgically via traditional open techniques. With recent emphasis on minimally invasive approaches in spine surgery, a number of new techniques has been introduced that are aimed at treating these 2 common pathological conditions. Currently the most widely used and efficacious minimally invasive technique for treating these disorders is direct decompression with minimally invasive surgery. Due to the scarcity of large randomized studies, however, it is difficult to compare the effectiveness and possible superiority of this technique with traditional decompression. Further studies are needed to evaluate this issue.

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Microscopic Laminotomies for Degenerative Lumbar Spinal Stenosis

Cited by 72 publications

References 0 publications

Bilateral versus unilateral interlaminar approach for bilateral decompression in patients with single-level degenerative lumbar spinal stenosis: a multicenter retrospective study of 175 patients on postoperative pain, functional disability, and patient satisfaction

Bilateral versus unilateral interlaminar approach for bilateral decompression in patients with single-level degenerative lumbar spinal stenosis: a multicenter retrospective study of 175 patients on postoperative pain, functional disability, and patient satisfaction

Quality of life and sociodemographic data in patients after spine surgery

Minimally invasive decompression for lumbar stenosis and disc herniation

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