Spinal canal morphology and clinical outcomes of microsurgical bilateral decompression via a unilateral approach for lumbar spinal canal stenosis

Choi, Won Seok; Oh, Chang Hyun; Ji, Gyu Yeul; Shin, Sung Chan; Lee, Jang Bo; Park, Dong Hyuk; Cho, Tai Hyoung

doi:10.1007/s00586-013-3116-7

Cited by 38 publications

(30 citation statements)

References 29 publications

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“…Based on the outcome results, they concluded that bilateral decompression via a unilateral approach may be a good modality for treating round or oval shape spinal canal stenosis, but they did not recommended it for trefoilshaped stenosis [43].…”

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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“…55 Stenosis may take place centrally at the central canal or laterally at the lateral recess, or the neural foramina. 8 Interplay of variable factors comprehensive of loss of height and herniation of intervertebral disc, facet joint thickening and hypertrophy of ligamentum flavum is the main pathophysiology leading up to reduced spinal canal diameter with subsequent compression of neural elements. 14,29,33 Compressioninduced ischemia of cauda equina and nerve roots provoke symptoms related to LCS which encompass neurogenic claudication described as buttock/ radiating leg pain with or without low back pain that get worsened with prolonged standing or walking and relieved with sitting or forward-leaning.…”

Section: Discussionmentioning

confidence: 99%

“…8 Johnsson et al, 23 1992 conducted a study upon LCS patients who were managed conservatively and followed-up for almost 4 consecutive years. Only 15% of the patients show symptomatic improvement with equal percentages get worsened.…”

Section: Discussionmentioning

confidence: 99%

Microendoscopic bilateral Decompression via Unilateral Approach in Single and Multiple Level Lumbar Canal Stenosis: A Series of 583 Cases

Kabil

Ebrahim

2017

Egyptian Spine Journal

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Background Data: Traditionally, lumbar canal stenosis (LCS) has been treated with conventional laminectomy involving wide resection of posterior supporting structures of the lumbar spine such as the supraspinous and inter-spinous ligamentum complex, the spinous process as well as wide areas of the lamina. In addition, this required a large incision of the skin and underlying musculoligamentous complex (posterior tension band). Purpose: The current study focuses on the clinical outcome and utility of minimally invasive microendoscopic decompression from a unilateral approach in surgical management of patients with single and multiple level lumbar canal stenosis. The objective is to describe the indications, significance and applications of endoscopic spine surgery in patients with single and multiple level LCS. Additionally, to highlight important anatomical perspectives of the technique and share surgical experience and results. Study Design: A retrospective clinical case study. Patients and Methods: From May 2008 to January 2016, 583 consecutive patients were treated for LCS and included in this study. Patients' main complaint was bilateral neurogenic claudication in addition to back pain and sciatic neuralgia. Single level decompression was performed in 468 (80%) patients and multiple level decompressions in 115 (20%) patients. Magnetic resonance imaging (MRI), computed tomography (CT) scan and plain X-rays were performed for all patients to confirm evidence of central stenosis and then repeated postoperatively. All patients were followed up for at least 3 months and their data collected. Clinical and functional outcomes were assessed using Visual Analogue Scale (VAS) and the Japanese Orthopedic Association Score (JOA) score for lumbar disease. Results: Compared to preoperative complaint, there was an improvement of back pain in 77.9% of patients and in radiating leg pain in 86.3%. With regards to functional outcomes, median preoperative JOA score was 14.93 ± 0.48 and improved postoperatively to 27.17 ± 1.45 (p < 0.001). The mean operating time per level was 78 minutes, and the mean intraoperative blood loss per level was 18 ml. Complications mainly included dural tears in 27 (4.6%) patients, transient postoperative dysesthesia in 46/583 (7.9%) patients and excess bony work in the form of unintended medial facetectomy in 38/583 (6.5%) patients and fracture of the spinous process in 3 (0.5%) patients.

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“…4 In addition, more work needs to be done in defining the adequate role of tubular minimally invasive laminectomies in patients with lumbar stenosis given radiological parameters other than spondylolisthesis, such as facet joint anatomy, disc height, foraminal compression, and spinal canal morphology. 2 We are currently studying the quality of contralateral versus ipsilateral decompression via a unilateral approach.…”

mentioning

confidence: 99%

“…Many of these procedures are now being performed via minimally invasive techniques. 2,4,5 The evolution of minimally invasive spine surgery has touched all aspects of lumbar spine pathology. Application of this technology has influenced the treatment of lumbar tumors, trauma, and deformity.…”

mentioning

confidence: 99%

Editorial: Minimally invasive spinal surgery and spinal stenosis

Arnold¹

2015

SPI

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Spinal canal morphology and clinical outcomes of microsurgical bilateral decompression via a unilateral approach for lumbar spinal canal stenosis

Cited by 38 publications

References 29 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

Microendoscopic bilateral Decompression via Unilateral Approach in Single and Multiple Level Lumbar Canal Stenosis: A Series of 583 Cases

Editorial: Minimally invasive spinal surgery and spinal stenosis

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