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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2019

Open Access 01-12-2019 | Laminectomy | Research article

Unilateral laminectomy for bilateral decompression improves low back pain while standing equally on both sides in patients with lumbar canal stenosis: analysis using a detailed visual analogue scale

Authors: Hiroshi Takahashi, Yasuchika Aoki, Junya Saito, Arata Nakajima, Masato Sonobe, Yorikazu Akatsu, Masahiro Inoue, Shinji Taniguchi, Manabu Yamada, Keita Koyama, Keiichiro Yamamoto, Yasuhiro Shiga, Kazuhide Inage, Sumihisa Orita, Satoshi Maki, Takeo Furuya, Masao Koda, Masashi Yamazaki, Seiji Ohtori, Koichi Nakagawa

Published in: BMC Musculoskeletal Disorders | Issue 1/2019

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Abstract

Background

Unilateral laminectomy for bilateral decompression (ULBD) for lumbar spinal stenosis (LSS) is a less invasive technique compared to conventional laminectomy. Recently, several authors have reported favorable results of low back pain (LBP) in patients of LSS treated with ULBD. However, the detailed changes and localization of LBP before and after ULBD for LSS remain unclear. Furthermore, unsymmetrical invasion to para-spinal muscle and facet joint may result in the residual unsymmetrical symptoms. To clarify these points, we conducted an observational study and used detailed visual analog scale (VAS) scores to evaluate the characteristics and bilateral changes of LBP and lower extremity symptoms.

Methods

We included 50 patients with LSS treated with ULBD. A detailed visual analogue scale (VAS; 100 mm) score of LBP in three different postural positions: motion, standing, and sitting, and bilateral VAS score (approached side versus opposite side) of LBP, lower extremity pain (LEP), and lower extremity numbness (LEN) were measured. Oswestry Disability Index (ODI) was used to quantify the clinical improvement.

Results

Detailed LBP VAS score before surgery was 51.5 ± 32.5 in motion, 63.0 ± 30.1 while standing, and 37.8 ± 31.8 while sitting; and showed LBP while standing was significantly greater than LBP while sitting (p < 0.01). After surgery, LBP while standing was significantly improved relative to that while sitting (p < 0.05), and levels of LBP in the three postures became almost the same with ODI improvement. Bilateral VAS scores showed significant improvement equally on both sides (p < 0.01).

Conclusions

ULBD improves LBP while standing equally on both sides in patients with LCS. The improvement of LBP by the ULBD surgery suggests radicular LBP improved because of decompression surgery. Furthermore, the symmetric improvement of LBP by the ULBD surgery suggests unsymmetrical invasion of the paraspinal muscles and facet joints is unrelated to residual LBP.
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Metadata
Title
Unilateral laminectomy for bilateral decompression improves low back pain while standing equally on both sides in patients with lumbar canal stenosis: analysis using a detailed visual analogue scale
Authors
Hiroshi Takahashi
Yasuchika Aoki
Junya Saito
Arata Nakajima
Masato Sonobe
Yorikazu Akatsu
Masahiro Inoue
Shinji Taniguchi
Manabu Yamada
Keita Koyama
Keiichiro Yamamoto
Yasuhiro Shiga
Kazuhide Inage
Sumihisa Orita
Satoshi Maki
Takeo Furuya
Masao Koda
Masashi Yamazaki
Seiji Ohtori
Koichi Nakagawa
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2019
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-019-2475-6

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