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KMID : 1189320140080060768
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Asian Spine Journal
2014 Volume.8 No. 6 p.768 ~ p.776
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Comparison of Spinous Process-Splitting Laminectomy versus Conventional Laminectomy for Lumbar Spinal Stenosis
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Uehara Masashi
Takahashi Jun
Hashidate Hiroyuki
Mukaiyama Keijiro
Kuraishi Shugo
Shimizu Masayuki
Ikegami Shota
Futatsugi Toshimasa
Ogihara Nobuhide
Hirabayashi Hiroki
Kato Hiroyuki
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Abstract
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Study Design: Seventy-five patients who had been treated for lumbar spinal stenosis (LSS) were reviewed retrospectively.
Purpose: Invasion into the paravertebral muscle can cause major problems after laminectomy for LSS. To address these problems, we performed spinous process-splitting laminectomy. We present a comparative study of decompression of LSS using 2 approaches.
Overview of Literature: There are no other study has investigated the lumbar spinal instability after spinous process-splitting laminectomy.
Methods: This study included 75 patients who underwent laminectomy for the treatment of LSS and who were observed through follow-ups for more than 2 years. Fifty-five patients underwent spinous process-splitting laminectomy (splitting group) and 20 patients underwent conventional laminectomy (conventional group). We evaluated the clinical and radiographic results of each surgical procedure.
Results: Japanese Orthopaedic Association score improved significantly in both groups two years postoperatively. The following values were all significantly lower, as shown with p-values, in the splitting group compared to the conventional group: average operating time (p=0.002), postoperative C-reactive protein level (p=0.006), the mean postoperative number of days until returning to normal body temperature (p=0.047), and the mean change in angulation 2 years postoperatively (p=0.007). The adjacent segment degeneration occurred in 6 patients (10.9%) in the splitting group and 11 patients (55.0%) in the conventional group.
Conclusions: In this study, the spinous process-splitting laminectomy was shown to be less invasive and more stable for patients with LSS, compared to the conventional laminectomy.
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KEYWORD
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Lumbar spinal stenosis, Spinous process-splitting laminectomy, Postoperative low back pain, Paravertebral muscle, posterior approach
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