Unilateral Laminotomy vs. Conventional Laminectomy: Which is Better for Degenerative Lumbar Spinal Stenosis?

Authors

  • Muhammad Jazib Ijaz
  • Yasir Shehzad
  • Soban Sarwar Gondal
  • Fraz Mehmood
  • Nadeem Akhtar
  • Eesha Yaqoob
  • Saad Javed

DOI:

https://doi.org/10.36552/pjns.v27i2.855

Abstract

Objectives:  To compare the outcomes of conventional laminectomy and unilateral laminotomy for lumbar spinal stenosis.

Materials and Methods:  The results of our research were compared between unilateral laminotomy (Group A) and conventional laminectomy (Group B) for lumbar spinal stenosis using a sample of 60 cases (30 in each group) selected through non-probability convenient sampling. We calculated the sample size using OPENEPI and analyzed the data with SPSS 26.0. For qualitative and quantitative data.

Results:  Mean age of participants was 49.7 years in both groups, The sample consisted of 37 male and 23 female participants made up the patient population. Dural tears (5%), progressive neurological deficit (0%), and surgical site infections (1%), among other postoperative complications, were all treated with antibiotics based on culture and sensitivity.

Conclusion:  Bilateral decompression via unilateral laminotomy is a less invasive alternative to conventional laminectomy for lumbar spinal stenosis, with significantly improved pain scores and minimized hospital stay. This technique offers appropriate decompression of neuronal components at the affected level with no increased risk of complications.

Keywords:  Degenerative, Spinal Stenosis, Unilateral Laminotomy, Conventional Laminectomy

References

Phan K, Mobbs RJ. Minimally invasive versus open laminectomy for lumbar stenosis: a systematic review and meta-analysis. Spine. 2020; 41 (2): E91-100.

Finneran MM, Naik A, Hawkins JC, Nardone EM. Minimally invasive bilateral decompressive lumbar laminectomy with the unilateral approach: patient series. JNS: Case Lessons, 2022; 3 (7).

Raffo CS, Lauerman WC. Predicting morbidity and mortality of lumbar spine arthrodesis in patients in their ninth decade. Spine, 2018; 31 (1): 99-103.

Dabasia H, Rahim N, Marshall R. Neurogenic claudication without spinal stenosis arising as a result of lumbar epidural varices. The Journal of bone and joint surgery. British Volume, 2021; 94 (9): 1292-4.

Lv B, Sun S, Wang H, Xiao L, Xu T, Ji P, Yuan J, Ding H, Xie J, Meng N, Zhang L. Clinical Efficacy and Rehabilitation of Microscopic “Over the Top” for Bilateral Decompression in Degenerative Lumbar Stenosis: A Retrospective Study. Bio Med Research International, 2020; 2020.

Thomé C, Zevgaridis D, Leheta O, Bäzner H, Pöckler-Schöniger C, Wöhrle J, Schmiedek P. Outcome after less-invasive decompression of lumbar spinal stenosis: a randomized comparison of unilateral laminotomy, bilateral laminotomy, and laminectomy. Journal of Neurosurgery: Spine, 2005; 3 (2): 129-41.

Hua W, Chen C, Feng X, Ke W, Wang B, Li S, Wang K, Zeng X, Wu X, Zhang Y, Liao Z. Clinical outcomes of uniportal and biportal lumbar endoscopic unilateral laminotomy for bilateral decompression in patients with lumbar spinal stenosis: A retrospective pair-matched case-control study. World Neurosurgery, 2022 Jan. 29.

Johnsson KE, Rosen I, Uden A. The natural course of lumbar spinal stenosis. Clinical Orthopaedics and Related Research, 1992; (279): 82-6.

Haig AJ, Geisser ME, Tong HC, Yamakawa KS, Quint DJ, Hoff JT, Chiodo A, Miner JA, Phalke VV. Electromyographic and magnetic resonance imaging to predict lumbar stenosis, low-back pain, and no back symptoms. JBJS. 2017; 89 (2): 358-66.

Dean AG, Sullivan KM, Soe MM. OpenEpi: Open Source Epidemiologic Statistics for Public Health, Version. www.OpenEpi.com.2013

Postacchini F. Surgical management of lumbar spinal stenosis. Spine (Phila Pa 1976), 1999; 24: 1043–104.

Haddadi K, Ganjeh Qazvini HR. Outcome after surgery of lumbar spinal stenosis: a randomized comparison of bilateral laminotomy, trumpet laminectomy, and conventional laminectomy. Frontiers in Surgery, 2020; 8; 3: 19.

Downloads

Published

2023-06-09

Issue

Section

Original Articles