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KMID : 0377220020270020068
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Medical Journal of Chosun Univercity
2002 Volume.27 No. 2 p.68 ~ p.73
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Foraminotomy for Patients with Foraminal Stenosis of Thoracolumbar Spine by Medial Sublaminar Approach or Paraspinal Approach
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Choi Yul
Shin Ho
Lee Seung-Myung
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Abstract
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Objective: Foraminal stenosis may be caused by various spinal diseases. In some of these patients, we conducted foraminotomy in a way which would not cause spinal instability.
Materials and Method: 31 patients who showed formainal stenosis on MRI underwent forminotomy between October of 2000 to August of 2001. Two types of technique were used. First method, medial sublaminar approach, in this approach we removed lower 1/3 of spinous process to the base, to expand interlaminar space, and exposed yellow ligament was removed. Through this hole, all sublaminar and foraminal part of yellow ligament was detached and removed under operating microscope. 2nd method, paraspinal approach, we removed intertransverse ligament and dilated the foramen by removal of yellow ligament composing posterior part of the foramen. Operation time was an hour in case of one level bilateral foraminal stenosis.
Results: The clinical state after surgery was assessed by Prologs outcome scale. Satisfactory results were obtained in 96%.
Conclusions: Although follow-up period was short(mean 18months), Laminar and facet joint damage was minimal, and as the result low back pain, and instability could be prevented with satisfactory results, but in spinal stenosis of L5-S1 level, these techniques were not appropriate.
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KEYWORD
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Foraminotomy, Medial sublaminar approach, Paraspinal approach
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