| Abstrakt: |
Introduction Tubular laminectomy is an effective treatment for lumbar spinal stenosis (LSS) with neurogenic claudication. Most surgeons familiar with the procedure agree that the tubular approach appears to afford a more complete decompression of the contralateral thecal sac and nerve root, as compared with the ipsilateral side. With this study, we sought to answer the question whether this is reflected in clinically significant differences between the ipsilateral and contralateral side pain improvements.Patients and Methods Patients with isolated LSS and equal preoperative leg VAS scores, who underwent a tubular (MIS) laminectomy between 2004 and 2011 were identified. The extent of VAS score improvement on the approach side was compared with the extent of improvement on the contralateral side, at the last follow-up. We tested the hypothesis that the pain relief would be the same on both sides regardless of the approach side.Results A total of 33 patients were included in our retrospective cohort. At the latest follow-up of 25.8 ± 3.4 months, there were statistically significant improvements in ODI and back VAS scores (p= 0.002 and p< 0.0001, respectively). In addition, buttock VAS scores were significantly improved both on the ipsilateral and the contralateral side (p< 0.001, and p= 0.001, respectively). Similarly, leg VAS scores were improved significantly on both the sides (p< 0.001, and p= 0.001, respectively). There were no statistically significant differences between the extent of pain improvement on the ipsilateral and the contralateral side, either for buttock or leg pain.Conclusions Minimally invasive tubular laminectomy through a unilateral approach results in clinically effective bilateral decompression. |
