Clinical and functional outcome of multiple laminotomy technique in the treatment of lumbar spinal stenosis

ABSTRACT

Lumbar spinal stenosis is the narrowing of the osteoligamentous vertebral canal causing compression of the neural elements within the spinal canal. the lateral recesses, or intervertebral foramina. Surgery aims to decompress the nervous structures, particularly the nerve roots. without compromising vertebral stability. Different surgical modalities have been implicated with different success rates. The purpose of this study is to assess the clinical and functional outcome after multiple laminotomy in treatment of lumbar spinal stenosis. Fifty-six patients with lumbar canal stenosis were operated on using the multiple laminotomy technique after adequate unsuccessful conservative treatment. Far lateral superior and inferior laminotomies limited to one half of the superior lamina and one quarter of the inferior lamina together with the intervening ligamentum flavum were performed. Attention was given to lateral recess and root canal decompression. In 8 patients multiple laminotomies failed to achieve adequate decompression due to absolute stenosis, and were excluded from the results. Patients were followed up for a mean period of 27.63 +/- 10.56 months and assessed according to the Japanese Orthopaedic association [JOA] score. Satisfactory [excellent and good] results were obtained in 87.5% of the patients with mean recovery rate of JOA score of 65% [P<0.000] Six minor dural tears without residual neurological signs were recorded. Permanent neurological [root] injury was recorded in only 2 patients. Results of the present study proved multiple laminotomy technique to be the procedure of choice for mild to moderate developmental and degenerative stenosis