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KMID : 0378019770200080081
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New Medical Journal
1977 Volume.20 No. 8 p.81 ~ p.88
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Study on Back Instability After Laminectomy and Discectomy
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Abstract
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Some patients have a satisfactory result for his profession after laminectomy and discectomy for lumbar herniated nucleus pulposus without adding spinal fusion while others do not.
The purpose of this study was to find the changes of the lumbar intervertebral joints and apophyseal joints after laminectomy for low back pain.
This investigation was based on the clinical and radiological changes before and after laminectomy for low back pain.
Forty-one cases who was complained of persisted low back pain, sciatica and muscle weakness after laminectomy and discectomy from January 1971 to December 1976.
All patients were evaluated by clinical symptoms and signs, and plain X-ray before and after surgery. The period between laminectomy and checking X-ray after laminectomy was varied from 6 months to 5 years with an average period of one year and four months. The age of the patients was varied from 20 years to 62 years with an average of- 36 years and 4 months.
They were performed patial, or hemilaminectomy or total laminectomy and disc removal, most frequently in 4th lumbar discs.
In this study it was measured that the changes of disc height of the operation site, and above and below intervertebral disc by Kataoka method, and changes of joint body line at the operation site, degree of lumbar lordosis, osteophyte and Ferguson angle before and after operation.
The results of the study led us to conclude that;
1. The disc height at the operation site is diminished in either partial or total laminectomy
and the degree of narrowing is corresponded with period of time after laminectomy.
2. The above adjacent intervertebral disc space has a tendency of widening but the below
one is narrow.
3. The total laminectomy and discectomy promotes insufficiency and instability of lumbar and lumbosacral spine. Whenever one attempt to do total laminectomy and discectomy, it is recommended that perform spine fusion at same operating field.
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