Efficacy and Safety of Using Unilateral Approach for Bilateral Neural Decompression in Lumbar Spinal Stenosis

Background Data: Lumbar spinal stenosis refers to the anatomical narrowing of the lumbar spinal canal, and is associated with a spectrum of clinical symptoms. The annual incidence of lumbar spinal stenosis is reported to be five cases per 100,000 individuals. Purpose: The purpose of this study is t...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Mohamed Abbas, Amr Elwany, Romany Farag
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2017
Materias:	unilateral approach conventional laminectomy hemilaminectomy lumbar spinal stenosis microscopic discectomy Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/18b8dbbada8849bd924f469ee95ac196
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:18b8dbbada8849bd924f469ee95ac196
record_format	dspace
spelling	oai:doaj.org-article:18b8dbbada8849bd924f469ee95ac1962021-12-02T00:39:56ZEfficacy and Safety of Using Unilateral Approach for Bilateral Neural Decompression in Lumbar Spinal StenosisDOI:10.21608/ESJ.2017.71492314-89502314-8969https://doaj.org/article/18b8dbbada8849bd924f469ee95ac1962017-10-01T00:00:00Zhttp://www.esj.journals.ekb.eg/article_7149.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Lumbar spinal stenosis refers to the anatomical narrowing of the lumbar spinal canal, and is associated with a spectrum of clinical symptoms. The annual incidence of lumbar spinal stenosis is reported to be five cases per 100,000 individuals. Purpose: The purpose of this study is to evaluate the surgical outcome of patients having lumbar spinal stenosis and underwent unilateral approach for bilateral spinal decompression surgery, and to compare outcomes with the conventional laminectomy approach. Study Design: This is a prospective randomized controlled study. Patients and Methods: This study included 21 patients with clinically manifest disco-ligamentous lumbar spinal stenosis without radiological instability. Eleven patients had bilateral neural decompression through a unilateral microscopic approach (unilateral laminectomy) (Group-I) and the other 10 patients had conventional laminectomy (Group-II).Clinical assessment was done using Visual Analogue Scale (VAS) and ODI. The patients were followed-up for 12 months postoperatively. Results: Thirteen patients were females and 8 were males. The mean age of unilateral approach group was 47.2 years, and 49.5 years for the conventional group. Reported duration of surgery was 100 minutes in group-I and 85 minutes group-II. Reported intraoperative blood loss was 84.7 cc in group-I, and 127 cc in group-II. Clinical improvement was achieved in both groups without significant difference in between regarding VAS and ODI. In group we reported unintended durotomy occurred in two patients, CSF leak in one patient, and hematoma in another patient. In group-I we had one patient of unintended durotomy, one patient had CSF leak, and one patient developed spondylolisthesis. Conclusion: Unilateral microscopic laminoforaminotomy with cross over the top technique, for bilateral neural decompression in lumbar spinal stenosis has equal efficacy and safety with minimal effect on stability and slight better postoperative back pain in comparison to conventional approach. (2017ESJ140)Mohamed Abbas Amr ElwanyRomany FaragEgyptian Spine Associationarticleunilateral approachconventional laminectomyhemilaminectomylumbar spinal stenosismicroscopic discectomyNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 24, Iss 1, Pp 42-49 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	unilateral approach conventional laminectomy hemilaminectomy lumbar spinal stenosis microscopic discectomy Neurology. Diseases of the nervous system RC346-429
spellingShingle	unilateral approach conventional laminectomy hemilaminectomy lumbar spinal stenosis microscopic discectomy Neurology. Diseases of the nervous system RC346-429 Mohamed Abbas Amr Elwany Romany Farag Efficacy and Safety of Using Unilateral Approach for Bilateral Neural Decompression in Lumbar Spinal Stenosis
description	Background Data: Lumbar spinal stenosis refers to the anatomical narrowing of the lumbar spinal canal, and is associated with a spectrum of clinical symptoms. The annual incidence of lumbar spinal stenosis is reported to be five cases per 100,000 individuals. Purpose: The purpose of this study is to evaluate the surgical outcome of patients having lumbar spinal stenosis and underwent unilateral approach for bilateral spinal decompression surgery, and to compare outcomes with the conventional laminectomy approach. Study Design: This is a prospective randomized controlled study. Patients and Methods: This study included 21 patients with clinically manifest disco-ligamentous lumbar spinal stenosis without radiological instability. Eleven patients had bilateral neural decompression through a unilateral microscopic approach (unilateral laminectomy) (Group-I) and the other 10 patients had conventional laminectomy (Group-II).Clinical assessment was done using Visual Analogue Scale (VAS) and ODI. The patients were followed-up for 12 months postoperatively. Results: Thirteen patients were females and 8 were males. The mean age of unilateral approach group was 47.2 years, and 49.5 years for the conventional group. Reported duration of surgery was 100 minutes in group-I and 85 minutes group-II. Reported intraoperative blood loss was 84.7 cc in group-I, and 127 cc in group-II. Clinical improvement was achieved in both groups without significant difference in between regarding VAS and ODI. In group we reported unintended durotomy occurred in two patients, CSF leak in one patient, and hematoma in another patient. In group-I we had one patient of unintended durotomy, one patient had CSF leak, and one patient developed spondylolisthesis. Conclusion: Unilateral microscopic laminoforaminotomy with cross over the top technique, for bilateral neural decompression in lumbar spinal stenosis has equal efficacy and safety with minimal effect on stability and slight better postoperative back pain in comparison to conventional approach. (2017ESJ140)
format	article
author	Mohamed Abbas Amr Elwany Romany Farag
author_facet	Mohamed Abbas Amr Elwany Romany Farag
author_sort	Mohamed Abbas
title	Efficacy and Safety of Using Unilateral Approach for Bilateral Neural Decompression in Lumbar Spinal Stenosis
title_short	Efficacy and Safety of Using Unilateral Approach for Bilateral Neural Decompression in Lumbar Spinal Stenosis
title_full	Efficacy and Safety of Using Unilateral Approach for Bilateral Neural Decompression in Lumbar Spinal Stenosis
title_fullStr	Efficacy and Safety of Using Unilateral Approach for Bilateral Neural Decompression in Lumbar Spinal Stenosis
title_full_unstemmed	Efficacy and Safety of Using Unilateral Approach for Bilateral Neural Decompression in Lumbar Spinal Stenosis
title_sort	efficacy and safety of using unilateral approach for bilateral neural decompression in lumbar spinal stenosis
publisher	Egyptian Spine Association
publishDate	2017
url	https://doaj.org/article/18b8dbbada8849bd924f469ee95ac196
work_keys_str_mv	AT mohamedabbas efficacyandsafetyofusingunilateralapproachforbilateralneuraldecompressioninlumbarspinalstenosis AT amrelwany efficacyandsafetyofusingunilateralapproachforbilateralneuraldecompressioninlumbarspinalstenosis AT romanyfarag efficacyandsafetyofusingunilateralapproachforbilateralneuraldecompressioninlumbarspinalstenosis
_version_	1718403541399240704

Efficacy and Safety of Using Unilateral Approach for Bilateral Neural Decompression in Lumbar Spinal Stenosis

Ejemplares similares