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ORIGINAL ARTICLE
Year : 2019  |  Volume : 32  |  Issue : 2  |  Page : 566-573

Different surgical modalities in the management of lumbar canal stenosis


1 Department of Neurosurgical, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of General Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Correspondence Address:
Mohamed K Eissa
2 Anwar Al-Sadat Street, Elbatanon, Shebinelkom, Menoufia 32511
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mmj.mmj_897_17

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Objective The aim of this study was to evaluate the results of different methods of decompression in lumbar canal stenosis (LCS) with regard to the effectiveness of different techniques in relieving symptoms, duration of surgery, intraoperative blood loss, and decreasing of postoperative complications. Background LCS is defined as a narrowing of any part of the lumbar spinal canal. Several surgical techniques for lumbar spine decompression have been described over the last few decades. The aim of surgery for symptomatic LCS is to relieve the symptoms by adequate neural decompression while preserving the anatomy and the biomechanical function of the lumbar spine as much as possible. Patients and methods This prospective study was conducted from September 2015 to August 2017 including three groups: group A treated with conventional laminectomy (CL), group B treated with CL with posterolateral fusion, and group C treated with unilateral laminectomy with bilateral decompression. We used Oswestry disability index to assess preoperative and postoperative disabilities and pain. Results In this study, statistical results revealed that there was statistical significance in the improvement of claudicating sciatica between the three groups as regards the Oswestry disability index (P < 0.001). There was statistical significance between three groups with regard to blood loss (P < 0.001), length of surgical procedure (P = 0.009), postoperative hospital stays (P < 0.001), and postoperative complication. Conclusion On the basis of short-term follow-up, a minimally invasive technique like unilateral laminectomy with bilateral decompression allowed decompression, preserving spine stability with a natural range of motion, with less blood loss, less hospital stay, and decreased intraoperative and postoperative complication rather than CL with or without posterolateral fusion.


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