Unilateral Undercutting Laminoplasty in the Treatment of Lumbar Spinal Stenosis: Comparison with Conventional Bilateral Partial Laminectomy

Lee, Jae Chul; Soh, Jae Wan; Hwang, Eun Chun; Kim, Yon Il; Shin, Byung Joon

Abstract

STUDY DESIGN: A retrospective study
OBJECTIVES
Contralateral undercutting laminoplasty via a unilateral laminotomy has been performed instead of bilateral partial laminectomy in lumbar spinal stenosis. This study compared the radiographic and clinical results of undercutting laminoplasty with bilateral partial laminectomy. SUMMARY OF LITERATURE REVIEW: Less invasive surgery has become attractive for minimizing soft tissue injury and reducing the recovery time.
MATERIALS AND METHODS
Twenty five patients, who underwent decompressive surgery for lumbar spinal stenosis and were followed-up more than one year, were enrolled in this study. Unilateral undercutting laminoplasty and bilateral partial laminectomy was performed in 13 and 12 cases, respectively. The blood loss was compared and the presence of instability was observed. The increase in dural cross sectional area was measured in the preoperative and postoperative CT scans. In the clinical assessment, the Oswestry disability index (ODI) and visual analogue scale (VAS) to pain was used.
RESULTS
The average blood loss per segment was 273 ml and 436 ml in the laminoplasty and laminectomy group. There was no case of instability after surgery but there was a significant difference in the increase in dural cross sectional area between the two groups: 109.7 mm2 and 78.6 mm2 in the laminoplasty and laminectomy group, respectively. The preoperative and final change in the ODI and VAS scores was similar between the two groups.
CONCLUSIONS
Unilateral undercutting laminoplasty is a minimally invasive procedure with less blood loss than the conventional technique and is equally effective.