Minimally invasive compared with open lumbar laminotomy: no functional benefits at 6 or 24 months after surgery

Ang, Chia-Liang; Tow, Benjamin Phak-Boon; Fook, Stephanie; Guo, Chang-Ming; Chen, John Li-Tat; Yue, Wai-Mun; Tan, Seck Guan

doi:10.1016/j.spinee.2013.07.461

Cited by 35 publications

(18 citation statements)

References 17 publications

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“…Ang et al study showed that although open and MIS lumbar laminotomy had similar functional scores at post-operative and 2-year follow-up time, the MIS technique was associated with higher complications rate. They concluded that for a relatively simple surgery such as laminotomy, the open approach remains a safe and straightforward option [38].…”

Section: Discussion Backgroundmentioning

confidence: 99%

Unilateral tubular approach for bilateral laminotomy: effect on ipsilateral and contralateral buttock and leg pain

et al. 2016

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Section: Discussion Backgroundmentioning

confidence: 99%

Unilateral tubular approach for bilateral laminotomy: effect on ipsilateral and contralateral buttock and leg pain

et al. 2016

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“…Conventional open surgery can well treated LLSC stenosis patients by resecting laminectomy and medial arthrotomy, however, the drawback was also obvious: more operation time, more recovery period and more complication [16].…”

Section: Discussionmentioning

confidence: 99%

The short-term effectiveness of precise safety decompression via two-time percutaneous lumbar foraminoplasty (TPLF) and percutaneous endoscopic lumbar decompression (PELD) for lumbar lateral spinal canal (LLSC) stenosis

Wang

Deng

et al. 2020

Preprint

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Purpose This prospective study reports a new technique: precise safety decompression via two-time percutaneous lumbar foraminoplasty (TPLF) and percutaneous endoscopic lumbar decompression (PELD) for lumbar lateral spinal canal (LLSC) stenosis, and short-term clinical outcomes.Methods 69 patients with single-level LLSC stenosis simultaneously occurred in both zone 1 and 2 who underwent TPLF-PELD from November 2018 to April 2019 were prospectively analyzed. Clinical outcomes were evaluated according to preoperative, 3 months postoperatively and last follow-up via leg pain/low back pain (LBP) visual analogue scale (VAS) scores, Oswestry disability index (ODI) scores and the Macnab criteria. The postoperative MRI and CT were used to confirm the complete decompression and flexion-extension X-Ray in last follow-up were used to observe lumbar stability.Results All patients successfully underwent TPLF-PELD and the stenosis was completely decompressed confirmed by post-operative MRI and CT. The mean follow-up duration was 13 months (range, 8-17 months). The mean preoperative leg pain VAS score is 7.05±1.04 (range 5-9), which decreased to 1.03±0.79(range 0-3) at third month postoperatively and to 0.75±0.63 (range 0-2) by the last follow-up visit. The mean preoperative ODI was 69.8±9.05 (range, 52-85), which decreased to 20.3±5.52 (range, 10-35) at the third month postoperatively and to 19.6±5.21 (range, 10-34) by the last follow-up visit. The satisfactory (excellent or good) results were 94.2%. There was 1 patients with aggravated symptoms which relieved after open surgery. 2 patients with dural tear and 2 patients with postoperative LBP. No recurrence and segmental instability was observed in the last follow-up.Conclusion TPLF-PELD could be a good alternative option for the treatment of LLSC stenosis patients whose stenotic region occurred in both zone 1 and 2.

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“…One such recently described MIStechnique is unilateral laminotomy for bilateral decompression (ULBD). This technique uses the microendoscopictubular-retractor system to preserve the facet joints and neural arch ofthe contralateral side, limits postoperative destabilization, andprotects the neural structures from extensive trauma.Ang et al [12], retrospectively reviewed the outcomes of 113 patients, measured by VAS for back and leg pain, the North American Spine Society score on neurogenic symptoms, found they were comparable between the ULBD and the open lumbar laminotomy groups,but ULBD was associated with the lower blood loss, the shorter hospital stay, the lower percentage of complications and the need for revisions.Although other studies have con rmed similar results [13], however, for elderly LSS patients over 75 years old, studies on the complications, clinical and radiographic outcomes of ULBD surgeries have seldom been reported.…”

Section: Discussionmentioning

confidence: 99%

Clinical and radiographic outcomes for microsurgical unilateral laminotomy for bilateral decompression of lumbar spinal stenosis for elderly patients-A retrospective cohort study

Lv¹

2020

Preprint

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BackgroundRecently, unilateral laminotomy for bilateral decompression (ULBD) has become a alternative to conventional decompression for symptomatic lumbar spinal stenosis (LSS),and this minimally invasive surgical technique has shown a satisfactory outcomes and low complications. However, the influence of old age on the risk of postoperative complications and clinical outcome is not well understood.OBJECTIVEThe purpose of this study was to evaluate clinical and radiographic outcomes and complication rates after ULBD in elderly patients.Study DesignSingle center retrospective observational study.SettingAll data was from the affiliated people's hospital of Jiangsu University.METHODSIn this study, 39 elderly patients were treated for lumbar spinal stenosis by ULBD between January 2016 and January 2018. Follow-up consisted of radiologic investigations, Visual Analog Scale, Oswestry Disability Index, and 36-Item Short-Form Health Survey at 6 and 12 months postoperatively. Preoperative comorbidity, postoperative complications and revision surgery rates were also analyzed.RESULTSThere were 12 female patients and 27 male patients with a mean age of 75.83 ± 9.16 years. 20 patients had one levels of spinal stenosis, 13 patients had two levels of stenosis, 6 patients had three levels of stenosis. Average follow-up time was 14.6 ± 7.8 months (range, 6–24 months), Total complications were 10.2%(4/39),and reoperation rate was 2.5%(1/39). Oswestry Disability Index scores decreased significantly (from 32.26 ± 6.82 to 11.44 ± 2.50 at 6 months and 10.56 ± 2.29 at 12 months), and 36-Item Short-Form Health Survey parameter scores demonstrated a significant improvement in the follow-up results.LimitationA multi-center study is recommended to confirm our findings and explore the factors related to clinical and radiographic outcomes.CONCLUSIONSULBD for lumbar spinal stenosis is a safe and effective treatment for elderly patients, improves these patients’ quality of life and does not pose an increased risk of complications.

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Minimally invasive compared with open lumbar laminotomy: no functional benefits at 6 or 24 months after surgery

Cited by 35 publications

References 17 publications

Unilateral tubular approach for bilateral laminotomy: effect on ipsilateral and contralateral buttock and leg pain

Unilateral tubular approach for bilateral laminotomy: effect on ipsilateral and contralateral buttock and leg pain

The short-term effectiveness of precise safety decompression via two-time percutaneous lumbar foraminoplasty (TPLF) and percutaneous endoscopic lumbar decompression (PELD) for lumbar lateral spinal canal (LLSC) stenosis

Clinical and radiographic outcomes for microsurgical unilateral laminotomy for bilateral decompression of lumbar spinal stenosis for elderly patients-A retrospective cohort study

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