A Clinical Study Of Laminotomy And Microdecompression For Treatment Of Lumbar Lateral Recess Syndrome

Objective: To investigate the surgical outcomes in patients with lumbar lateral recess syndrome treated with laminotomy and microdecompression, we could make clear of the advantages of the new surgical procedure and could summarized some possible causes that greatly influenced its curative effect, with which we could provide a reliable evidence for its clinical application and could expect a better curative effect.Methods: 64 patients had been performed operations with two surgical decompression procedures respectively from January 2000 to September 2003. They were divided into two groups for different surgical procedures, one group (microdecompression group) was treated with microwounded lumbar laminotomy and limited decompression in 34 cases. The other group (extensive decompression group) was treated with laminectomy or total laminectomy and complete decompression in 30 cases. The operation index of two groups such as incision length, blood loss and operation time were reviewed. The average period of follow-up studies was 2.3 years. Postoperative recovery state was measured with JOA evaluation score and the excellent-good rates of two groups were calculated. According to lumbar instability standard, the incidences of lumbar instability were compared in two groups by taking hyperextension and hyperflexion X-ray films.Results: (1) In microdecompression group, the length of operation incision and the operation time were short, and the blood loss was relatively little. (2)The good rate of microdecompression group was 91.2% and extensive decompression group was 83.3%. There wasn't statistically difference between two groups (P>0.05). 3 There was no case of lumbar instability in microdecompression group, and the incidence of lumbar instability in extensive decompression group was 13.3%. There was statistically significant difference between two groups (P<0.05). (4) Complications in extensive decompression group were more frequent to happen than in microdecompression group.Conclusion: The microdecompressive surgery of keeping the posterior column structure in the maximal degree could adequately decompress and assure the spinal stability to a certain extent with satisfactory surgical results. Being shortness of observation cases, the future curative effect need the further observation.