Effectiveness of Unilateral Approach for Bilateral Decompression in Lumber Spinal Stenosis
Keywords:Bilateral decompression, Lumbar spinal stenosis, Unilateral approach, Efficacy
Background: Lumbar spinal stenosis is defined as “buttock or lower extremity pain, which may occur with or without low back pain, associated with diminished space available for the neural and vascular elements in the lumbar spine. Patients complain of neurogenic claudication that is compatible with a narrowing of the lumbar spinal canal. Conventional laminectomy is frequently associated with surgical failures, generally related to postoperative iatrogenic spinal instability. Other operative options that are less invasive, such as the bilateral laminotomy and, in particular, the unilateral laminotomy for bilateral decompression (ULBD), have been introduced during the past years.
Objectives: The objective of this study is to determine the effectiveness of unilateral approach for bilateral decompression in Lumbar spinal stenosis.
Methods: It was a Descriptive case series study conducted in the admitted patients of Lumbar spinal stenosis in the Department of Neurosurgery, Lady Reading Hospital, Peshawar, in six months duration. Total of 171 patients were enrolled in the study. Bilateral decompression through a unilateral approach was performed under general anesthesia by single expert neurosurgeon having a minimum of 5 years of experience. All the patients were followed up till 24 hours post operatively for the determination of effectiveness in terms of improvement in at least one grade of pain on visual analogue scale from baseline.
Results: In this study, 171 patients with Lumbar spinal stenosis were observed. Male to female ratio was 1.41:1. The study included age ranged from 40 to 78 years. Average age was 59.29 years ± 11.41 SD. Efficacy of unilateral approach for bilateral decompression in Lumbar spinal stenosis was found in 136 (79.53%).
Conclusion: Unilateral approach for bilateral decompression is the better option for the patients presenting with Lumbar spinal stenosis.
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