Journal article
Spinal canal morphology and clinical outcomes of microsurgical bilateral decompression via a unilateral approach for lumbar spinal canal stenosis
European spine journal, Vol.23(5), pp.991-998
05/01/2014
DOI: 10.1007/s00586-013-3116-7
PMID: 24292345
Abstract
Microsurgical bilateral decompression via a unilateral approach for lumbar spinal stenosis is a less invasive technique compared to conventional laminectomy. Although many technical reports have demonstrated acceptable overall surgical outcomes for this approach, no studies have attempted to clarify the clinical outcomes thereof in regard to anatomical variance of the spinal canal. This study was conducted to analyze the clinical outcomes of microsurgical bilateral decompression via a unilateral approach according to spinal canal morphology in degenerative lumbar spinal stenosis.
Between January 2008 and December 2009, 144 patients with single-level spinal lumbar stenosis underwent microsurgical bilateral decompression via a unilateral approach by a single surgeon. Patients were categorized into three groups according to spinal canal shape: round (n = 42), oval (n = 36), and trefoil (n = 66), and clinical parameters were assessed both before and after surgery with 2-3 years of follow-up.
Mean visual analog scale (VAS) and Oswestry disability index (ODI) decreased after surgery, respectively, from 8.1 and 59.8 % to 2.1 and 19.1 % in the round shaped spinal canal group, from 7.2 and 47.1 % to 2.2 and 15.1 % in the oval shaped spinal canal group, and from 6.8 and 53.6 % to 3.6 and 33.3 % in the trefoil shaped spinal canal group. In all groups, VAS and ODI scores significantly improved postoperatively (p < 0.01), although less improved VAS and ODI scores were observed in the trefoil shaped spinal canal group (p < 0.01). The overall patient satisfaction rate was 66.7 %; however, statistically significant lower satisfaction rates were reported in the trefoil shaped spinal canal group (p < 0.01).
Microsurgical bilateral decompression via a unilateral approach may be a good modality for treating round or oval shape spinal canal stenosis, but is not recommended for trefoil-shaped-stenosis. The current authors recommend performing the bilateral decompression technique in cases of trefoil-shaped-spinal canal stenosis.
Details
- Title: Subtitle
- Spinal canal morphology and clinical outcomes of microsurgical bilateral decompression via a unilateral approach for lumbar spinal canal stenosis
- Creators
- Won-Seok Choi - Guro Teun Teun Hosp, Spine & Joint Res Inst, Dept Neurosurg, Seoul, South KoreaChang Hyun Oh - Guro Teun Teun Hosp, Spine & Joint Res Inst, Dept Neurosurg, Seoul, South KoreaGyu Yeul Ji - Yonsei UniversitySung Chan Shin - Jangan Dong Teun Teun Hosp, Dept Neurosurg, Seoul, South KoreaJang-Bo Lee - Korea UniversityDong-Hyuk Park - Korea UniversityTai-Hyoung Cho - Korea University
- Resource Type
- Journal article
- Publication Details
- European spine journal, Vol.23(5), pp.991-998
- Publisher
- Springer Nature
- DOI
- 10.1007/s00586-013-3116-7
- PMID
- 24292345
- ISSN
- 0940-6719
- eISSN
- 1432-0932
- Number of pages
- 8
- Language
- English
- Date published
- 05/01/2014
- Academic Unit
- Neurosurgery
- Record Identifier
- 9984460339702771
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