Unilateral Laminotomy versus Conventional Laminectomy in Treatment of Lumbar Canal Stenosis: A Prospective Comparative Study

Background Data: Lumbar spinal stenosis is common in elderly and obese patients. Surgical intervention should be considered only after all conservative treatment options have been proven unsuccessful. Wide laminectomy was the gold standard of treatment, but surgical failures have been reported. Rece...

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Autores principales:	Ahmad Abdalla, MD., Mohamed A. Ragaee, MD.
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2019
Materias:	lumbar canal stenosis unilateral laminotomy Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/d22a9ffa131f4c28a46224dd71e21fc9
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spelling	oai:doaj.org-article:d22a9ffa131f4c28a46224dd71e21fc92021-12-02T15:32:32ZUnilateral Laminotomy versus Conventional Laminectomy in Treatment of Lumbar Canal Stenosis: A Prospective Comparative Study10.21608/esj.2020.17351.11052314-89502314-8969https://doaj.org/article/d22a9ffa131f4c28a46224dd71e21fc92019-10-01T00:00:00Zhttps://www.esj.journals.ekb.eg/article_80117_eaf8ad39ece5f4f15b0e69071e43384a.pdfhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Lumbar spinal stenosis is common in elderly and obese patients. Surgical intervention should be considered only after all conservative treatment options have been proven unsuccessful. Wide laminectomy was the gold standard of treatment, but surgical failures have been reported. Recently, a less invasive decompressive surgical procedures have emerged as an alternative technique. Purpose: To compare between the unilateral laminotomy approach and conventional laminectomy approach for the treatment of lumbar canal stenosis, regarding clinical outcomes. Study Design: This is a prospective clinical randomized controlled study. Patients and Methods: This study included 30 patients with lumbar canal stenosis. 15 patients underwent unilateral laminotomy approach (Group A), while the other 15 patients underwent conventional laminectomy approach (Group B). Surgical operative time, blood loss, and hospital stay were recorded. Clinical outcomes have been assessed by Visual Analogue Scale (VAS) of leg pain and Oswestry Disability Index (ODI). Patients were followed up for 1 year postoperatively. Results: Male to female ratio was 12:18 patients. The mean age was 52.5±6.62 years in Group A and 52.2±7.24 years in Group B. The mean operative time was 73.5±14.54 minutes in Group A and 85.5±17.07 minutes in Group B. Less blood loss was recorded in Group A (127±37.43 ml) than Group B (152±50.95 ml). Three patients suffered unintended durotomy in both groups and no postoperative CSF leak occurred. Marked reduction of VAS and ODI was achieved in both groups at one-year follow-up without statistically significant difference. Conclusion: Unilateral laminotomy approach used for bilateral neural compression is an effective technique for treatment of lumbar canal stenosis in comparison to conventional laminectomy approach. (2019ESJ184) Ahmad Abdalla, MD.Mohamed A. Ragaee, MD.Egyptian Spine Associationarticlelumbar canal stenosisunilateral laminotomyNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 32, Iss 1, Pp 10-18 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	lumbar canal stenosis unilateral laminotomy Neurology. Diseases of the nervous system RC346-429
spellingShingle	lumbar canal stenosis unilateral laminotomy Neurology. Diseases of the nervous system RC346-429 Ahmad Abdalla, MD. Mohamed A. Ragaee, MD. Unilateral Laminotomy versus Conventional Laminectomy in Treatment of Lumbar Canal Stenosis: A Prospective Comparative Study
description	Background Data: Lumbar spinal stenosis is common in elderly and obese patients. Surgical intervention should be considered only after all conservative treatment options have been proven unsuccessful. Wide laminectomy was the gold standard of treatment, but surgical failures have been reported. Recently, a less invasive decompressive surgical procedures have emerged as an alternative technique. Purpose: To compare between the unilateral laminotomy approach and conventional laminectomy approach for the treatment of lumbar canal stenosis, regarding clinical outcomes. Study Design: This is a prospective clinical randomized controlled study. Patients and Methods: This study included 30 patients with lumbar canal stenosis. 15 patients underwent unilateral laminotomy approach (Group A), while the other 15 patients underwent conventional laminectomy approach (Group B). Surgical operative time, blood loss, and hospital stay were recorded. Clinical outcomes have been assessed by Visual Analogue Scale (VAS) of leg pain and Oswestry Disability Index (ODI). Patients were followed up for 1 year postoperatively. Results: Male to female ratio was 12:18 patients. The mean age was 52.5±6.62 years in Group A and 52.2±7.24 years in Group B. The mean operative time was 73.5±14.54 minutes in Group A and 85.5±17.07 minutes in Group B. Less blood loss was recorded in Group A (127±37.43 ml) than Group B (152±50.95 ml). Three patients suffered unintended durotomy in both groups and no postoperative CSF leak occurred. Marked reduction of VAS and ODI was achieved in both groups at one-year follow-up without statistically significant difference. Conclusion: Unilateral laminotomy approach used for bilateral neural compression is an effective technique for treatment of lumbar canal stenosis in comparison to conventional laminectomy approach. (2019ESJ184)
format	article
author	Ahmad Abdalla, MD. Mohamed A. Ragaee, MD.
author_facet	Ahmad Abdalla, MD. Mohamed A. Ragaee, MD.
author_sort	Ahmad Abdalla, MD.
title	Unilateral Laminotomy versus Conventional Laminectomy in Treatment of Lumbar Canal Stenosis: A Prospective Comparative Study
title_short	Unilateral Laminotomy versus Conventional Laminectomy in Treatment of Lumbar Canal Stenosis: A Prospective Comparative Study
title_full	Unilateral Laminotomy versus Conventional Laminectomy in Treatment of Lumbar Canal Stenosis: A Prospective Comparative Study
title_fullStr	Unilateral Laminotomy versus Conventional Laminectomy in Treatment of Lumbar Canal Stenosis: A Prospective Comparative Study
title_full_unstemmed	Unilateral Laminotomy versus Conventional Laminectomy in Treatment of Lumbar Canal Stenosis: A Prospective Comparative Study
title_sort	unilateral laminotomy versus conventional laminectomy in treatment of lumbar canal stenosis: a prospective comparative study
publisher	Egyptian Spine Association
publishDate	2019
url	https://doaj.org/article/d22a9ffa131f4c28a46224dd71e21fc9
work_keys_str_mv	AT ahmadabdallamd unilaterallaminotomyversusconventionallaminectomyintreatmentoflumbarcanalstenosisaprospectivecomparativestudy AT mohamedaragaeemd unilaterallaminotomyversusconventionallaminectomyintreatmentoflumbarcanalstenosisaprospectivecomparativestudy
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Unilateral Laminotomy versus Conventional Laminectomy in Treatment of Lumbar Canal Stenosis: A Prospective Comparative Study

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