A comparative study of bilateral laminotomy and laminectomy with fusion for lumbar stenosis

ABSTRACT

Laminectomy with fusion and bilateral laminotomy as a fenestration method have been used to improve pain, neurogenic claudication and neurological impairment in lumbar stenosis. To date it is not known whether the two surgical procedures have the same effectiveness in this degenerative disease. This is a retrospective review of 105 consecutive patients with lumbar stenosis who underwent surgery at the Sanglah General Hospital, Bali between 2005 and 2008. The aim of this study was to compare the results of bilateral laminotomy and laminectomy with fusion for canal decompression in lumbar stenosis. The study consisted of 46 patients who underwent bilateral laminotomy and 59 patients treated by laminectomy with fusion. The follow up ranged from 3-36 months. The outcome was evaluated by the Visual Analog Scale (VAS), Neurogenic Claudication Outcome Score (NCOS), and the Oswestry Disability Index (ODI) scores. The means of postoperative VAS for both groups were 2.6 + 0.9, postoperative NCOS for both groups were 64.0 + 13.9 and postoperative ODI for both groups were 24.4 + 7.9. There was no clinical deterioration and side effect from the operative procedure. Our results show that bilateral laminotomy and laminectomy with fusion are equally effective over a short follow up. However, bilateral laminotomy is a less invasive procedure.