ABSTRACT
OBJECT: Microscopic bilateral decompression through a unilateral laminotomy (MBDUL) is a minimally invasive technique used to treat lumbar canal stenosis (LCS). In the present study, MBDUL was performed to treat LCS in eight patients undergoing hemodialysis. METHODS: Surgical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) scale (highest possible score 29). The JOA scale was administered preoperatively, at 1 month and 3 months postoperatively, and at the final follow-up examination. One patient refused to undergo the postoperative assessment after the 1-month examination; the mean follow-up duration of the remaining seven patients was 24 months (range 18-31 months). The mean age at the time of surgery was 62 years (range 48-76 years), and the mean duration of hemodialysis therapy was 21.4 years (range 3-28 years). All patients could walk within 2 days of surgery. The mean angle of the straight leg-raising (SLR) test was 53.8 degrees preoperatively, and this increased to 69.4 degrees postoperatively. Six patients felt enhancement of sciatica or leg pain when performing the SLR test preoperatively, a finding that was absent postoperatively at least until the final follow-up examination. The mean preoperative JOA score was 11.6 (range 4-22), and the score markedly improved to 19.8 (range 15-23) at 1 month and 20.6 (range 16-25) at 3 months. The mean JOA score decreased to 17.1 (range 12-25) at the final follow-up examination, but this decrease was attributed to other physical disorders. CONCLUSIONS: The authors conclude that MBDUL is a safe and effective surgical treatment for patients undergoing hemodialysis who are suffering from LCS.
