J Neurol Surg A Cent Eur Neurosurg 2020; 81(06): 475-483
DOI: 10.1055/s-0040-1701621
Original Article

Radiologic Efficacy and Patient Satisfaction after Minimally Invasive Unilateral Laminotomy and Bilateral Decompression in Patients with Lumbar Spinal Stenosis: A Retrospective Analysis

Seung-Kook Kim
1   Himchan UHS Joint and Spine Centre, University Hospital Sharjah, Sharjah, United Arab Emirates
2   Department of Pharmaceutical Medicine and Regulatory Sciences, College of Medicine and Pharmacy, Yonsei University, Incheon, Republic of Korea
3   Joint and Arthritis Research, Orthopaedic Surgery, Himchan Hospital, Seoul, Republic of Korea
,
Sungmo Ryu
4   Department of Neurosurgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
,
Eun-Sang Kim
4   Department of Neurosurgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
,
Sun-Ho Lee
4   Department of Neurosurgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
,
Su-Chan Lee
3   Joint and Arthritis Research, Orthopaedic Surgery, Himchan Hospital, Seoul, Republic of Korea
› Author Affiliations

Abstract

Background and Study Aims Lumbar spinal stenosis (LSS) is the most common spinal disease in older adults. Although surgical modalities are recommended in patients who are unresponsive to conservative treatment, the most appropriate minimally invasive surgical procedure for patients with LSS remains controversial. Moreover, few previous studies have focused on patient-centered outcomes with radiologic correlation. In the present study, we aimed to investigate radiologic efficacy and patient satisfaction following bilateral decompression via unilateral laminotomy.

Materials and Methods We performed a retrospective analysis of radiologic efficacy and patient satisfaction in a series of surgical patients treated at our institution. We classified patients into two groups based on the primary pathology (i.e., central or lateral recess stenosis). Medical records were analyzed retrospectively for radiologic outcomes and clinical parameters including pain and changes in quality of life. Data related to outcomes were collected at 2 weeks, 3 months, and 12 months after surgery in the outpatient clinic.

Results Among the 122 patients enrolled in this study, 51 had central spinal stenosis; 71 had lateral recess stenosis. Radiologically, we observed significant improvements in the anteroposterior diameter and cross-sectional area of the dural sac (central stenosis) and the lateral width of the central canal and depth of the lateral recess (lateral recess stenosis). Two weeks and 12 months after the surgical procedure, we observed significant improvements in the extent of symptoms, patient satisfaction, and quality of life (including physical function).

Conclusion Our findings suggest that bilateral decompression via a unilateral approach shows improved radiologic outcomes, varying based on the type of stenosis. Furthermore, patient satisfaction significantly improved regardless of the type of disease.



Publication History

Received: 31 May 2019

Accepted: 03 July 2019

Article published online:
15 May 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Stuttgart · New York

 
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