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Abstract
Study Design and Objectives
In the treatment of lumbar spinal stenosis, a less invasive technique is preferred, for which good results have been observed. In this study, 34 patients who had undergone a bilateral microscopic laminotomy for lumbar spinal stenosis were retrospectively investigated.
Materials and Methods
Thirty- four patients with lumbar spinal stenosis who had undergone a bilateral microscopic laminotomy, between March 1997 and December 2000 were reviewed. The subjects comprised of 18 men and 16 women, with a median age of 46.1years. The average follow- up period was 32 months. Demographic data and the durations of back and radiating pains of these patients were analyzed. For the prognostic factors, the clinical outcomes were analyzed using the McNab's criteria, and the postoperative instability, ambulation time after surgery, hospital stay, operative time and complications reviewed.
Results
The analysis showed excellent, good, fair and poor results in 12, 12, 6 and 4 patients, respectively. The satisfaction rate with the surgery was over 70.6%. The average length of hospital stay, operative time and estimated intraoperative blood loss were 7.3 days, 109minutes and 160cc, respectively. A longer duration of lower back pain (p=0.0154) was associated with a poor result, whereas increasing age (p=0.1884), gender (p=1.0) and duration of radiating pain (P=0.4449) showed no statistical significance.
Conclusion
A bilateral microscopic laminotomy can be used as a less invasive technique for lumbar spinal stenosis, with which satisfactory results are usually achieved. It may be especially beneficial in young patient with lower back pain of only a short duration. However, late postoperative instability should be carefully observed.
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Table 1.
Results in Fair and Poor cases
| Case No. | Age/Sex | Level | discectomy | Ambulation | ∗ HS | Op. time | † EBL | ‡ Cx & Inst | Cormodity |
|---|---|---|---|---|---|---|---|---|---|
| Fair | |||||||||
| 1 | 22/M | L4-5 | + | 7 | 14 | 100 | 140 | dura tear | |
| 2 | 38/F | L4-5 | + | 2 | 5 | 100 | 200 | ||
| 3 | 49/M | L4-5 | + | 3 | 7 | 120 | 200 | ||
| 4 | 52/M | L4-5 | + | 2 | 7 | 130 | 150 | ||
| 5 | 49/F | L5-S1 | + | 2 | 7 | 130 | 150 | Inst. | |
| 6 | 76/F | L4-5 | - | 3 | 7 | 100 | 100 | Inst. | ¶ HET |
| Poor | |||||||||
| 1 | 44/M | L2-3,L4-5 | - | 3 | 6 | 210 | 300 | incomplete, inst. | HET |
| 2 | 50/M | L3-4,L4-5 | - | 3 | 7 | 120 | 100 | incomplete | HET |
| 3 | 61/F | L3-4,L4-5 | + | 3 | 17 | 100 | 100 | inst. | angina, thyroid dz |
| 4 | 64/F | L4-5 | + | 2 | 14 | 70 | 80 | inst. | HET,DM. |
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