291714

Outcomes after decompressive laminectomy for lumbar spinal stenosis: comparison between minimally invasive unilateral laminectomy for bilateral decompression versus open laminect

Article

Last updated: 04 Jan 2025

Subjects

-

Tags

Surgery ·

Abstract

Background:  Lumbar spinal stenosis (LSS) is typically caused by degenerative facet joint , ligament hypertrophy, and broad-based disc bulging, leading to lateral recess and lumber  canal compression, resulting in walking debility and also leg pain. LSS is a progressive degenerative disease that most commonly affects elderly patients over 60 years old and can significantly impact the daily activities and quality of life leading to progressive disability. Aim: comparing the outcomes following minimally invasive unilateral laminectomy for bilateral decompression (ULBD) to standard open laminectomy for lumbar spinal stenosis. Patients & Methods: Randomized controlled prospective clinical trial- single-blinded study for 30 patients with lumbar canal stenosis who were randomly allocated to one of the two interventional groups; group (A) 15 patients underwent conventional Laminectomy, group (B) 15 patients underwent microsurgical decompression from March 2019 till March 2021 in a bani-siuf university and cairo university   department of neurosurgery. Results: There was no statistically significant difference between both groups regarding the motor power, sensory nerve affection, straight leg raising, and stenotic level (p-value >0.05). Four patients (26.6%) in group A presented with motor affection (ankle dorsiflexion grade 2_3) versus one patient in group B presented motor affection (ankle dorsiflexion grade 4). Five patients (16.7%) presented with sensory affection. SLR was affected in 6 patients (20%). L4-5 was the more level affected  (58%)  then  L3-4 (26%) and L5-S1 (16%). 7 patients (23.3%) need  discectomy. Conclusion: This study demonstrated the possibility of decompressing the lumber canal by the use of a unilateral approach. Surgical  experience is mandatory to adequately decompress the neural structures. ULBD is effective as laminectomy in the treatment of  LSS with the benefit of respecting the integrity of the neural elements with a little amount of blood loss.

DOI

10.21608/ejmr.2023.198805.1363

Keywords

conventional, Decompressing, Laminectomy, lumbar spinal stenosis, microsurgical

Authors

First Name

Mohamed

Last Name

Shaban

MiddleName

-

Affiliation

Department of Neurosurgery, Beni-Suef University, Egypt

Email

shabanneuro@gmail.con

City

-

Orcid

-

First Name

Ahmed

Last Name

Mostafa

MiddleName

Gaber

Affiliation

Department of Orthoptic surgery, Beni-Suef University, Egypt

Email

ahmedga911@gmail.com

City

Bani suif

Orcid

-

First Name

Ahmed

Last Name

Abdelwahed

MiddleName

S. Kamel

Affiliation

Department of Neurosurgery, Cairo University Egypt

Email

askamel@gmail.com

City

-

Orcid

-

Volume

4

Article Issue

1

Related Issue

38807

Issue Date

2023-01-01

Receive Date

2023-03-08

Publish Date

2023-01-01

Page Start

130

Page End

145

Print ISSN

2682-4396

Online ISSN

2682-440X

Link

https://ejmr.journals.ekb.eg/article_291714.html

Detail API

https://ejmr.journals.ekb.eg/service?article_code=291714

Order

291,714

Type

Original Article

Type Code

1,224

Publication Type

Journal

Publication Title

Egyptian Journal of Medical Research

Publication Link

https://ejmr.journals.ekb.eg/

MainTitle

Outcomes after decompressive laminectomy for lumbar spinal stenosis: comparison between minimally invasive unilateral laminectomy for bilateral decompression versus open laminect

Details

Type

Article

Created At

25 Dec 2024