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KMID : 1189320140080040462
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Asian Spine Journal
2014 Volume.8 No. 4 p.462 ~ p.468
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Limited Laminectomy and Restorative Spinoplasty in Spinal Canal Stenosis
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Sangwan Sukhbir Singh
Garg Rakesh
Gogna Paritosh
Kundu Zile Singh
Gupta Vinay
Kamboj Pradeep
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Abstract
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Study Design: Prospective cohort study.
Purpose: Evaluation of the clinico-radiological outcome and complications of limited laminectomy and restorative spinoplasty in spinal canal stenosis.
Overview of Literature: It is critical to achieve adequate spinal decompression, while maintaining spinal stability.
Methods: Forty-four patients with degenerative lumbar canal stenosis underwent limited laminectomy and restorative spinoplasty at our centre from July 2008 to December 2010. Four patients were lost to follow-up leaving a total of 40 patients at an average final follow-up of 32 months (range, 24-41 months). There were 26 females and 14 males. The mean±standard deviation (SD) of the age was 64.7±7.6 years (range, 55-88 years). The final outcome was assessed using the Japanese Orthopaedic Association (JOA) score.
Results: At the time of the final follow-up, all patients recorded marked improvement in their symptoms, with only 2 patients complaining of occasional mild back pain and 1 patient complaining of occasional mild leg pain. The mean±SD for the preoperative claudication distance was 95.2±62.5 m, which improved to 582±147.7 m after the operation, and the preoperative anterio-posterior canal diameter as measured on the computed tomography scan was 8.3±2.1 mm, which improved to 13.2±1.8 mm postoperatively. The JOA score improved from a mean±SD of 13.3±4.1 to 22.9±4.1 at the time of the final follow-up. As for complications, dural tears occurred in 2 patients, for which repair was performed with no additional treatment needed.
Conclusions: Limited laminectomy and restorative spinoplasty is an efficient surgical procedure which relieves neurogenic claudication by achieving sufficient decompression of the cord with maintenance of spinal stability.
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KEYWORD
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Lumbar spine, Lumbar canal stenosis, Decompression, Limited laminectomy, Spinoplasty
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