A COMPARATIVE STUDY BETWEEN TRADITIONAL FULL LAMINECTOMIES AND MICROSURGICAL BILATERAL DECOMPRESSION BY UNILATERAL APPROACH IN TREATMENT OF LUMBAR CANAL STENOSIS

Abstract

Background: Microscopic unilateral approach for bilateral decompression became an alternative surgery for
traditional full laminectomy resulting in better outcomes for patients as well as avoiding extensive bony loss.
Objective: to evaluate clinical outcomes of unilateral laminectomy approach for bilateral decompression (ULBD) to
those of traditional full laminectomies as a treatment of Lumbar Canal Stenosis (LCS).
Subjects and methods: Three-hundred LCS patients were included in the study subdivided into two equally groups.
Group A patients operated upon with traditional full laminectomies; group B operated upon with unilateral approach
for bilateral decompression. Clinical and radiological data were assessed. VAS score and ODI were used to measure
patient-reported outcome.
Results: Group A and group B (LCS) had a mean age of 46.9±11 and 53.2±6.9 respectively. There was no
statistically significant difference between groups as regards number of levels of decompression (p-value>0.05).
Pre-operative and post-operative clinical assessment for patients were done. Results revealed significant
improvement of ODI and VAS for leg pain in both groups where in group I, the mean ODI decreased from
50.1±10.1 to 27.1±6.7, and the mean VAS decreased from 8.1±0.7 to 2.9±1.2. Group B, the mean ODI decreased
from 46.7±9.9% to 22.5±11.1%, and the mean VAS decreased from 7.5±1.4 to 2.5±1.2. As for the back pain, VAS
score decreased in group A from 5.1±1.4 to 4.7±1.7 and in group B from 4.2±2.1 to 2.8±1.2.
Conclusion: Both techniques are effective procedures for LCS treatment, however ULBD had better outcome
regarding postoperative back pain but with longer length of operation.