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European Spine Journal
Published in: European Spine Journal 5/2009

01-05-2009 | Original Article

Clinical outcomes of microendoscopic decompressive laminotomy for degenerative lumbar spinal stenosis

Authors: Jwo-Luen Pao, Wein-Chin Chen, Po-Quang Chen

Published in: European Spine Journal | Issue 5/2009

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Abstract

The goal of surgical treatment for degenerative lumbar spinal stenosis (LSS) is to effectively relieve the neural structures by various decompressive techniques. Microendoscopic decompressive laminotomy (MEDL) is an attractive option because of its minimally invasive nature. The aim of prospective study was to investigate the effectiveness of MEDL by evaluating the clinical outcomes with patient-oriented scoring systems. Sixty consecutive patients receiving MEDL between December 2005 and April 2007 were enrolled. The indications of surgery were moderate to severe stenosis, persistent neurological symptoms, and failure of conservative treatment. The patients with mechanical back pain, more than grade I spondylolisthesis, or radiographic signs of instability were not included. A total of 53 patients (36 women and 17 men, mean age 62.0) were included. Forty-five patients (84.9%) were satisfied with the treatment result after a follow-up period of 15.7 months (12–24). The clinical outcomes were evaluated with the Oswestry disability index (ODI) and the Japanese Orthopedic Association (JOA) score. Of the 50 patients providing sufficient data for analysis, the ODI improved from 64.3 ± 20.0 to 16.7 ± 20.0. The JOA score improved from 9.4 ± 6.1 to 24.2 ± 6.0. The improvement rate was 73.9 ± 30.7% and 40 patients (80%) had good or excellent results. There were 11 surgical complications: dural tear in 5, wrong level operation in 2, and transient neuralgia in 4 patients. No wound-related complication was noted. Although the prevalence of pre-operative comorbidities was very high (69.8%), there was no serious medical complication. There was no post-operative instability at the operated segment as evaluated with dynamic radiographs at final follow-up. We concluded that MEDL is a safe and very effective minimally invasive technique for degenerative LSS. With an appropriate patient selection, the risk of post-operative instability is minimal.
Literature
1.
2.
3.
Athiviraham A, Yen D (2007) Is spinal stenosis better treated surgically or nonsurgically? Clin Orthop Relat Res 458:90–93PubMed
4.
Atlas SJ, Deyo RA, Keller RB, Chapin AM, Patrick DL, Long JM, Singer DE (1996) The Maine Lumbar Spine Study, Part III. 1-year outcomes of surgical and nonsurgical management of lumbar spinal stenosis. Spine 21:1787–1794. doi:10.​1097/​00007632-199608010-00012 discussion 1794–1785PubMedCrossRef
5.
6.
Cavusoglu H, Kaya RA, Turkmenoglu ON, Tuncer C, Colak I, Aydin Y (2007) Midterm outcome after unilateral approach for bilateral decompression of lumbar spinal stenosis: 5-year prospective study. Eur Spine J 16:2133–2142. doi:10.​1007/​s00586-007-0471-2 PubMedCrossRef
7.
Costa F, Sassi M, Cardia A, Ortolina A, De Santis A, Luccarell G, Fornari M (2007) Degenerative lumbar spinal stenosis: analysis of results in a series of 374 patients treated with unilateral laminotomy for bilateral microdecompression. J Neurosurg 7:579–586
8.
9.
10.
Fu YS, Zeng BF, Xu JG (2008) Long-term outcomes of two different decompressive techniques for lumbar spinal stenosis. Spine 33:514–518PubMedCrossRef
11.
12.
13.
14.
Ikuta K, Arima J, Tanaka T, Oga M, Nakano S, Sasaki K, Goshi K, Yo M, Fukagawa S (2005) Short-term results of microendoscopic posterior decompression for lumbar spinal stenosis. Technical note. J Neurosurg 2:624–633
15.
16.
Khoo LT, Fessler RG (2002) Microendoscopic decompressive laminotomy for the treatment of lumbar stenosis. Neurosurgery 51:S146–S154PubMed
17.
18.
19.
Lin SM, Tseng SH, Yang JC, Tu CC (2006) Chimney sublaminar decompression for degenerative lumbar spinal stenosis. J Neurosurg 4:359–364
20.
Malmivaara A, Slatis P, Heliovaara M, Sainio P, Kinnunen H, Kankare J, Dalin-Hirvonen N, Seitsalo S, Herno A, Kortekangas P, Niinimaki T, Ronty H, Tallroth K, Turunen V, Knekt P, Harkanen T, Hurri H (2007) Surgical or nonoperative treatment for lumbar spinal stenosis? A randomized controlled trial. Spine 32:1–8. doi:10.​1097/​01.​brs.​0000251014.​81875.​6d PubMedCrossRef
21.
22.
Niggemeyer O, Strauss JM, Schulitz KP (1997) Comparison of surgical procedures for degenerative lumbar spinal stenosis: a meta-analysis of the literature from 1975 to 1995. Eur Spine J 6:423–429. doi:10.​1007/​BF01834073 PubMedCrossRef
23.
24.
Oertel MF, Ryang YM, Korinth MC, Gilsbach JM, Rohde V (2006) Long-term results of microsurgical treatment of lumbar spinal stenosis by unilateral laminotomy for bilateral decompression. Neurosurgery 59:1264–1269 discussion 1269–1270PubMed
25.
Palmer S, Turner R, Palmer R (2002) Bilateral decompression of lumbar spinal stenosis involving a unilateral approach with microscope and tubular retractor system. J Neurosurg 97:213–217PubMed
26.
Postacchini F, Cinotti G (1992) Bone regrowth after surgical decompression for lumbar spinal stenosis. The Journal of Bone and Joint Surgery 74:862–869
27.
Rosen DS, O’Toole JE, Eichholz KM, Hrubes M, Huo D, Sandhu FA, Fessler RG (2007) Minimally invasive lumbar spinal decompression in the elderly: outcomes of 50 patients aged 75 years and older. Neurosurgery 60:503–509 discussion 509–510PubMed
28.
Thome C, Zevgaridis D, Leheta O, Bazner H, Pockler-Schoniger C, Wohrle J, Schmiedek P (2005) Outcome after less-invasive decompression of lumbar spinal stenosis: a randomized comparison of unilateral laminotomy, bilateral laminotomy, and laminectomy. J Neurosurg 3:129–141
29.
Truumees E (2005) Spinal stenosis: pathophysiology, clinical and radiologic classification. Instr Course Lect 54:287–302PubMed
30.
31.
32.
Weinstein JN, Lurie JD, Tosteson TD, Hanscom B, Tosteson AN, Blood EA, Birkmeyer NJ, Hilibrand AS, Herkowitz H, Cammisa FP, Albert TJ, Emery SE, Lenke LG, Abdu WA, Longley M, Errico TJ, Hu SS (2007) Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis. N Engl J Med 356:2257–2270. doi:10.​1056/​NEJMoa070302 PubMedCrossRef
33.
Wiltse LL, Kirkaldy-Willis WH, McIvor GW (1976) The treatment of spinal stenosis. Clin Orthop Relat Res 115:83–91PubMed
Metadata
Title
Clinical outcomes of microendoscopic decompressive laminotomy for degenerative lumbar spinal stenosis
Authors
Jwo-Luen Pao
Wein-Chin Chen
Po-Quang Chen
Publication date
01-05-2009
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue 5/2009
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-009-0903-2

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