Sublaminar Decompression and Fusion Versus Sublaminar Trimming Laminoplasty: a Retrospective Cohort.

Abstract

Abstract Background: Many surgical options for treating lumbar degenerative disorders have been used to improve health related outcome of those patients. The aim of the study is to compare the functional and radiological outcome of the two techniques in management of Lumbar spinal stenosis (LSS). Methods: Sixty patients with Lumbar spinal stenosis were included in a retrospective cohort study at zagazig university hospital. The inclusion criteria were patients with single level LSS with back and /or leg pain with instability on dynamic radiology not responding to medical treatment. We excluded patients with pathological fracture, high grade spondylolisthesis and infection. Patients were divided into two groups according to the method of treatment done. Group one included patients with sublaminar trimming Laminoplasty with instrumented fusion. The second group included patients with sublaminar decompression with instrumented fusion. Patients were assessed clinically using visual analogue scale (VAS) for back and leg pain and the Owestry Disability Index (ODI) for the disability. Plain x-ray, CT and MRI was done for all patients preoperative and we measured AP-thecal sac area, foraminal height and the thecal sac area for all patients (pre- and post-operative). Results: comparing both groups there were no difference in relation to demographic data nor in the diagnosis of the spinal stenosis. Group-2 had longer hospital stay. Both groups improved clinically post-operatively with no statistical difference between them. However, the rate of improvement in group-2 in relation to leg pain was better. Both groups improved radiologically, but AP-thecal sac area, foraminal height and the thecal sac area were much improved in group-2 (p-value<0.001) in comparison to group-1. Conclusion: Sublaminar decompression can particularly achieve better central, foraminal and lateral recess decompression together with a better fusion rate and hence, can be used as alternative to different laminotomy decompression techniques for treating different lumbar degenerative disorders.