Microsurgical Unilateral Approach for Bilateral Decompression of Segmental Lumbar Canal Stenosis

Abstract

Lumbar canal stenosis is a common disease with disabling sequences to the patient either due to the disease itself or due to the common surgical procedures which aim to decompress the canal but with much common complications due to removal of the posterior complex (bone and ligaments) of the stenosed segment causing more chance for instability of the spine, much trauma to the other tissues (e.g. muscles of the back on both sides), much scare tissue formation, dead space, postoperative pain and impaired quality of life. The microscopic bilateral decompression by only unilateral laminectomy aims to preserve stability by preserving midline structures like spinous process, intraspinous and supra spinous ligaments and facet joint besides proper dural and foraminal decompression. In this study, it was noticed that this procedure produce proper decompression of segmental spinal stenosis regarding post operative radiological studies, which revealed adequate decompression of the stenosed segment regarding measuring canal cross-sectional area and dimensions both pre and postoperative, and clinically regarding estimating clinical improvement of the patients by estimating low back pain and lower limb pain by visual analogue scale before and after the operation with follow up after one week, 3 months and 6 months, which revealed proper clinical improvement. Patient quality of life was estimated by using Oswestry Disability Index and questionnaire, pre and postoperative after one week, 3 months and 6 months, which revealed proper improvement of the quality of patient life after such procedure.