Treatment of degenerative lumbar spinal disorder by enlargement of the spinal canal with spinous process osteotomy / 中华骨科杂志

ABSTRACT

Objective To evaluate the surgical outcomes in patients with lumbar disorder treated with enlargement of the spinal canal through spinous process osteotomy. Methods Posterior central incision was used for unilateral exposure of lamina. Osteotomy was done at the base of the spinous process; complete exposure of the lamina was done by retracting the interspinous and supraspinous ligaments. Ligament flaven was resected at the superior and inferior margin of the lamina. Undermining enlargment of the central spinal canal and the neural canal were then carried out; in some cases the intervertebral disc was resected. Thirty seven patients suffered from lumbar spinal stenosis were treated with the above mentioned procedure; among them decompression of a single segment was done in 24 cases, in two segments in 13 cases. Postoperatively, Oswestry evaluation score and imaging observation were carried out. Results Thirty four cases had follow up for one year and the excellent and good results was seen in 82.4%; 27 cases had follow up of 3 years, the rate of excellent and good results was 81.5%. Both sagittal and transverse diameter of lumbar vertebrae canal were increased notably in postoperative CT scanning. 87% of osteotomized spinous processes had bony fusion. Conclusion Spinal canal plasty by spinous process osteotomy for patients with lumbar disorders affords easy performing procedure with less complications and satisfactory surgical results.