Clinical and Radiological Outcomes after Microscopic Bilateral Decompression via a Unilateral Approach for Degenerative Lumbar Disease: Minimum 5-Year Follow-Up
Asian Spine Journal
;
: 285-293, 2017.
Article
Dans Anglais
| WPRIM
| ID: wpr-10341
ABSTRACT
STUDY DESIGN:
A retrospective study.PURPOSE:
To assess postoperative bone regrowth at surgical sites after lumbar decompression with >5 years of follow-up. Postoperative preservation of facet joints and segmental spinal instability following surgery were also evaluated. OVERVIEW OF LITERATURE Previous reports have documented bone regrowth after conventional laminectomy or laminotomy and several factors associated with new bone formation.METHODS:
Forty-nine patients who underwent microscopic bilateral decompression via a unilateral approach at L4–5 were reviewed. Primary outcomes included correlations among postoperative bone regrowth, preservation of facet joints, radiographic parameters, and clinical outcomes. Secondary outcomes included comparative analyses of radiographic parameters and clinical outcomes among preoperative diagnoses (lumbar spinal stenosis, degenerative spondylolisthesis, and degenerative lumbar scoliosis).RESULTS:
The average value of bone regrowth at the latest follow-up was significantly higher on the dorsal side of the facet joint (3.4 mm) than on the ventral side (1.3 mm). Percent facet joint preservation was significantly smaller on the approach side (79.2%) than on the contralateral side (95.2%). Bone regrowth showed a significant inverse correlation with age, but no significant correlation was observed with facet joint preservation, gender, postoperative segmental spinal motion, or clinical outcomes. Subanalysis of these data revealed that bone regrowth at the latest follow-up was significantly greater in patients with degenerative lumbar scoliosis than in those with lumbar spinal stenosis. Postoperative segmental spinal motion at L4–L5 did not progress significantly in patients with degenerative spondylolisthesis or degenerative lumbar scoliosis compared with those with lumbar spinal stenosis.CONCLUSIONS:
Microscopic bilateral decompression via a unilateral approach prevents postoperative spinal instability because of satisfactory preservation of facet joints, which may be the primary reason for inadequate bone regrowth. Postoperative bone regrowth was not related to clinical outcomes and postoperative segmental spinal instability.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Ostéogenèse
/
Scoliose
/
Sténose du canal vertébral
/
Développement osseux
/
Spondylolisthésis
/
Études rétrospectives
/
Études de suivi
/
Résultat thérapeutique
/
Interventions chirurgicales mini-invasives
/
Articulation zygapophysaire
Type d'étude:
Etude diagnostique
/
Étude observationnelle
/
Étude pronostique
/
Facteurs de risque
Limites du sujet:
Humains
langue:
Anglais
Texte intégral:
Asian Spine Journal
Année:
2017
Type:
Article
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