Assessment of Clinical Outcome of Bilateral Decompression through Unilateral Approach in Lumbar Canal Stenosis

Background Data: Acquired degenerative lumbar canal stenosis is considered a common indication for lumbar spine surgery in old patients. The traditional approach is wide open laminectomy, medial facetectomy, and foraminotomy, which includes bilateral muscle separation and extensive excision of the p...

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Autores principales:	Emad Abouelmaaty, Shafik El Molla
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2017
Materias:	lumbar canal stenosis degenerative decompression unilateral Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/3787b7a864eb46819e15beca6a5a24af
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spelling	oai:doaj.org-article:3787b7a864eb46819e15beca6a5a24af2021-12-02T00:39:51ZAssessment of Clinical Outcome of Bilateral Decompression through Unilateral Approach in Lumbar Canal StenosisDOI:10.21608/ESJ.2017.55222314-89502314-8969https://doaj.org/article/3787b7a864eb46819e15beca6a5a24af2017-01-01T00:00:00Zhttp://www.esj.journals.ekb.eg/article_5522.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Acquired degenerative lumbar canal stenosis is considered a common indication for lumbar spine surgery in old patients. The traditional approach is wide open laminectomy, medial facetectomy, and foraminotomy, which includes bilateral muscle separation and extensive excision of the posterior spinal structures. Minimal invasive surgeries as microsurgical and endoscopic have been now used for the treatment of lumbar canal stenosis during the last years. Purpose: To assess clinical outcome of unilateral approach in bilateral decompression of lumbar canal stenosis. Study Design: Observational analytic prospective study. Patients and Methods: Twenty patients with degenerative lumbar canal stenosis have undergone bilateral decompression from unilateral approach at Ain Shams university hospitals between May 2014 and April 2016. Prospective analysis of their clinical outcome was conducted. Results: In this study twelve were male (60%) and eight were female (40%). The mean age was 43.1±12.33 (range 35-55years). The duration of clinical presentation ranged from 6 to 24 months. Preoperative clinical presentation was low back pain (95%), sciatica (85%), neurogenic claudication (100%) and sensory changes (80%). Marked improvement of preoperative leg pain has been observed after surgical decompression. Significant reduction of the mean preoperative VAS (7±0.72) (over all back and leg pain) to VAS 2±0.72) at one, (1.85± 0.58) at three and (1.6± 0.68) at 6 months (P>0.001). The mean ODI scores decreased significantly at one (27±9.78), three (23±7.3) and six months (21±4.47) from the mean preoperative ODI score (61±4.47) (P>0.0001). Accidental durotomy was reported in one patient (5%) and it was in the posterior dura under the opposite lamina just off the midline. Conclusion: Unilateral approach in bilateral decompression is an effective procedure for management of lumbar canal stenosis. (2016ESJ119)Emad AbouelmaatyShafik El MollaEgyptian Spine Associationarticlelumbar canal stenosisdegenerativedecompressionunilateralNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 21, Iss 1, Pp 24-32 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	lumbar canal stenosis degenerative decompression unilateral Neurology. Diseases of the nervous system RC346-429
spellingShingle	lumbar canal stenosis degenerative decompression unilateral Neurology. Diseases of the nervous system RC346-429 Emad Abouelmaaty Shafik El Molla Assessment of Clinical Outcome of Bilateral Decompression through Unilateral Approach in Lumbar Canal Stenosis
description	Background Data: Acquired degenerative lumbar canal stenosis is considered a common indication for lumbar spine surgery in old patients. The traditional approach is wide open laminectomy, medial facetectomy, and foraminotomy, which includes bilateral muscle separation and extensive excision of the posterior spinal structures. Minimal invasive surgeries as microsurgical and endoscopic have been now used for the treatment of lumbar canal stenosis during the last years. Purpose: To assess clinical outcome of unilateral approach in bilateral decompression of lumbar canal stenosis. Study Design: Observational analytic prospective study. Patients and Methods: Twenty patients with degenerative lumbar canal stenosis have undergone bilateral decompression from unilateral approach at Ain Shams university hospitals between May 2014 and April 2016. Prospective analysis of their clinical outcome was conducted. Results: In this study twelve were male (60%) and eight were female (40%). The mean age was 43.1±12.33 (range 35-55years). The duration of clinical presentation ranged from 6 to 24 months. Preoperative clinical presentation was low back pain (95%), sciatica (85%), neurogenic claudication (100%) and sensory changes (80%). Marked improvement of preoperative leg pain has been observed after surgical decompression. Significant reduction of the mean preoperative VAS (7±0.72) (over all back and leg pain) to VAS 2±0.72) at one, (1.85± 0.58) at three and (1.6± 0.68) at 6 months (P>0.001). The mean ODI scores decreased significantly at one (27±9.78), three (23±7.3) and six months (21±4.47) from the mean preoperative ODI score (61±4.47) (P>0.0001). Accidental durotomy was reported in one patient (5%) and it was in the posterior dura under the opposite lamina just off the midline. Conclusion: Unilateral approach in bilateral decompression is an effective procedure for management of lumbar canal stenosis. (2016ESJ119)
format	article
author	Emad Abouelmaaty Shafik El Molla
author_facet	Emad Abouelmaaty Shafik El Molla
author_sort	Emad Abouelmaaty
title	Assessment of Clinical Outcome of Bilateral Decompression through Unilateral Approach in Lumbar Canal Stenosis
title_short	Assessment of Clinical Outcome of Bilateral Decompression through Unilateral Approach in Lumbar Canal Stenosis
title_full	Assessment of Clinical Outcome of Bilateral Decompression through Unilateral Approach in Lumbar Canal Stenosis
title_fullStr	Assessment of Clinical Outcome of Bilateral Decompression through Unilateral Approach in Lumbar Canal Stenosis
title_full_unstemmed	Assessment of Clinical Outcome of Bilateral Decompression through Unilateral Approach in Lumbar Canal Stenosis
title_sort	assessment of clinical outcome of bilateral decompression through unilateral approach in lumbar canal stenosis
publisher	Egyptian Spine Association
publishDate	2017
url	https://doaj.org/article/3787b7a864eb46819e15beca6a5a24af
work_keys_str_mv	AT emadabouelmaaty assessmentofclinicaloutcomeofbilateraldecompressionthroughunilateralapproachinlumbarcanalstenosis AT shafikelmolla assessmentofclinicaloutcomeofbilateraldecompressionthroughunilateralapproachinlumbarcanalstenosis
_version_	1718403547335229440

Assessment of Clinical Outcome of Bilateral Decompression through Unilateral Approach in Lumbar Canal Stenosis

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