Long-term outcomes of two different decompressive techniques for lumbar spinal stenosis.

摘要

STUDY DESIGN: A prospective study to evaluate the outcomes of 2 different decompressive techniques for lumbar spinal stenosis. OBJECTIVE: To explore a more effective and less invasive decompression technique without instrument and fusion for lumbar spinal stenosis. SUMMARY OF BACKGROUND DATA: The traditional surgical decompression of spinal stenosis involves laminectomy or unilateral laminotomy. Even in unilateral laminotomy cases, 85.3% had an excellent-to-fair operative result, and the incidence of complications was 9.8%. Although the addition of instrumentation does not increase the complication rate, but compared to the efficiency, the higher costs was controversial. Minimal invasion and destabilization are recommended. METHODS: This prospective study included 152 consecutive patients, sequentially divided into 2 groups, underwent Windows technique (group A) and decompressive laminectomy (group B) by 2 groups of surgeons. RESULTS: The evaluation of the back pain, leg pain, walking tolerance, and neurologic recovery were performed before surgery and after surgery. In group A, at the final evaluation, the overall results were good to excellent in 89% (68/76) of the patients, fair 11% (8/76), and poor 0%. In group B, at the final evaluation, the overall results were good to excellent in 63% (48/76) of the patients, fair 30% (23/76), and poor 7% (5/76). CONCLUSION: Degenerative spinal stenosis can be decompressed adequately with preserving the posterior elements. The "Windows technique" laminoforaminotomy, which obtained satisfactory long-term outcomes with few complications and low cost, can be a standard procedure for the surgical treatment of the degenerative spinal stenosis even with slight congenital spinal stenosis.