Decompression of lumbar canal stenosis with a bilateral interlaminar versus classic laminectomy technique: a prospective randomized study

Soliman, Mohamed A.R.; Ali, Ahmed M.

doi:10.3171/2019.2.focus18725

Cited by 15 publications

(19 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 48 50 A recent study compared the radiological and clinical results of bilateral interlaminar decompression and laminectomy. 51 However, this study was a single-centre study, was not blinded, and did not include a computerised randomisation. Furthermore, there were no data regarding the cost-effectiveness of both surgical interventions.…”

Section: Discussionmentioning

confidence: 99%

SIZE study: study protocol of a multicentre, randomised controlled trial to compare the effectiveness of an interarcuair decompression versus extended decompression in patients with intermittent neurogenic claudication caused by lumbar spinal stenosis

et al. 2020

View full text Add to dashboard Cite

IntroductionIntermittent neurogenic claudication (INC) is often caused by lumbar spinal stenosis (LSS). Laminectomy is considered a frequently used surgical technique for LSS. Previous studies have shown that laminectomy can potentially cause lumbar instability. Less invasive techniques, preserving midline structures including the bilateral small size interarcuair decompression, are currently applied. Due to lack of evidence and consensus, surgeons have to rely on their training and own experiences to choose the best surgical techniques for their patients. Hence, an observer and patient blinded multicentre, randomised controlled trial was designed to determine the effectiveness and cost-effectiveness of bilateral interarcuair decompression versus laminectomy for LSS.Methods and analysis174 patients above 40 years with at least 12 weeks of INC will be recruited. Patients are eligible for inclusion if they have a clinical indication for surgery for INC with an MRI showing signs of LSS. Patients will be randomised to laminectomy or bilateral interarcuair decompression. The primary outcome is functional status measured with the Roland-Morris Disability Questionnaire at 12 months. Secondary outcomes consist of pain intensity, self-perceived recovery, functional status measured with the Oswestry Disability Index and a physical examination. Outcome measurement moments will be scheduled at 3 and 6 weeks, and at 3, 6, 12, 18, 24, 36 and 48 months after surgery. Physical examination will be performed at 6 weeks, and 12, 24 and 48 months. An economic evaluation will be performed and questionnaires will be used to collect cost data.Ethics and disseminationThe Medical Ethical Committee of the Erasmus Medical Centre Rotterdam approved this study (NL.65826.078.18). The results will be published in an international peer-reviewed journal.Trial registration numberClinicalTrials.gov (NCT03480893).IRB approval statusMEC-2018-093.

show abstract

Section: Discussionmentioning

confidence: 99%

SIZE study: study protocol of a multicentre, randomised controlled trial to compare the effectiveness of an interarcuair decompression versus extended decompression in patients with intermittent neurogenic claudication caused by lumbar spinal stenosis

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Forty-four articles were retained for a comprehensive evaluation. Finally, 14 trials including 1,106 participants were included in the final analysis (5)(6)(7)(8)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). Supplementary Table S4 showed characteristics of the included trials and participants.…”

Section: Systematic Review and Qualitative Assessmentmentioning

confidence: 99%

“…Wide resection of bone, ligament, and muscle structures results in increased postoperative pain, blood loss, complications, and length of hospital stay ( 5 , 6 ). Recently, a number of experts have recommended surgical techniques that preserve posterior midline structures ( 5 , 7 , 8 ). Removal of midline structures may lead to postoperative spinal instability ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

Comparison of posterior decompression techniques and conventional laminectomy for lumbar spinal stenosis

et al. 2022

View full text Add to dashboard Cite

ObjectivesTo compare the efficacy of posterior decompression techniques with conventional laminectomy for lumbar spinal stenosis.MethodsThe Embase, PubMed, and Cochrane Library databases were searched with no language limitations from inception to January 13, 2022. The main outcomes were functional disability, perceived recovery, leg and back pain, complications. A random effects model was used to pooled data. Risk ratio (RR), mean difference (MD) and 95% confidence interval (CI) were used to report results. The study protocol was published in PROSPERO (CRD42022302218).Results14 trials including 1,106 participants were included in the final analysis. Bilateral laminotomy was significantly more efficacious in improve functionality than laminectomy [MD: −2.94; (95% CI, −4.12 to −1.76)]. Low incidence of iatrogenic instability due to bilateral laminectomy compared with laminectomy [RR: 0.11; (95% CI, 0.02 to 0.59)]. In addition, between those who received bilateral laminotomy and those undergoing laminectomy, the result showed significant difference regarding recovery [RR: 1.31; (95% CI, 1.03 to 1.67)].ConclusionsThis study provides evidence that bilateral laminotomy has advantages in functional recovery, postoperative stability, and postoperative rehabilitation outcomes. Further research is needed to determine whether posterior techniques provide a safe and effective option for conventional laminectomy.

show abstract

“…The development of endoscopic surgery in lumbar decompression also has become practical choice for decompression in herniated nucleus pulposus (HNP) as well as in degenerative lumbar canal stenosis (LCS), with various techniques being adopted to address underlying pathologies (uniportal vs. biportal, unilateral vs. bilateral decompression) [7], [8], [9]. A prospective study by Soliman and Ali [10] compares the outcome of LCS surgery using minimally invasive decompression with microscope and the conventional open laminectomy. They found that MD permits safe and acceptable spinal canal decompression in patients with LCS.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Microscopic Decompression and Biportal Endoscopic Spinal Surgery in the Treatment of Lumbar Canal Stenosis and Herniated Disc: A One-year Follow-up

Librianto

Ipang²,

Saleh³

et al. 2022

Open Access Maced J Med Sci

View full text Add to dashboard Cite

Backgrounds. Microscopic decompression (MD) has been widely used as an alternative to open decompression. Lately, biportal endoscopic spinal surgery (BESS) - a new approach in minimal-invasive spinal surgery – has also been used with good results. Although both groups can achieve adequate lumbar decompression, there is still a lack of evidence regarding their comparison. We aim to compare the outcomes of both techniques in a one-year follow-up. Methods. This is a retrospective study in 100 consecutive patients with symptomatic lumbar spine compression due to herniated nucleus pulposus (HNP) and lumbar canal stenosis (LCS) that was treated by either BESS or MD. Clinical evaluations using Visual Analog Score (VAS), Oswestry Disability Index (ODI), and SF-36 questionnaire were obtained. Objective data such as surgery duration, amount of postoperative drain production, and hospital length of stay were collected. Complications were noted throughout the follow-up time. Results. The BESS group had a significantly lesser surgical duration, drain production, and length of stay. At one year follow-up, both groups achieved significant improvement in VAS, ODI, and SF-36 compared to the preoperative condition. Complications were not observed in the BESS group. Conclusions. Both procedures were comparably effective to treat lumbar stenosis. Although this study shows superiority with BESS technique in immediate and long-term follow-up, the final choice may depend on the surgeon's preference

show abstract

Decompression of lumbar canal stenosis with a bilateral interlaminar versus classic laminectomy technique: a prospective randomized study

Cited by 15 publications

References 42 publications

SIZE study: study protocol of a multicentre, randomised controlled trial to compare the effectiveness of an interarcuair decompression versus extended decompression in patients with intermittent neurogenic claudication caused by lumbar spinal stenosis

SIZE study: study protocol of a multicentre, randomised controlled trial to compare the effectiveness of an interarcuair decompression versus extended decompression in patients with intermittent neurogenic claudication caused by lumbar spinal stenosis

Comparison of posterior decompression techniques and conventional laminectomy for lumbar spinal stenosis

Comparison of Microscopic Decompression and Biportal Endoscopic Spinal Surgery in the Treatment of Lumbar Canal Stenosis and Herniated Disc: A One-year Follow-up

Contact Info

Product

Resources

About