Outcomes of Surgical Decompression Approaches in Patients with Lumbar Spinal Stenosis: Conventional VS Minimal Invasive VS Addition of Fixation

Ahmed Nagaty; Hesham Radwan; Mohamed Helmy Abd Elshafouk; Ahmad Elsabaa

doi:doi:10.11648/j.ijn.20220602.17

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Outcomes of Surgical Decompression Approaches in Patients with Lumbar Spinal Stenosis: Conventional VS Minimal Invasive VS Addition of Fixation

Ahmed Nagaty, Hesham Radwan, Mohamed Helmy Abd Elshafouk, Ahmad Elsabaa

Published in International Journal of Neurosurgery (Volume 6, Issue 2)

Received: 7 September 2022 Accepted: 26 September 2022 Published: 11 October 2022

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Abstract

Background: Lumbar spinal stenosis is one of the commonest causes of patients’ disability due to degenerative disorders. Surgery have been found to be a more effective in relieve of patients’ symptoms and improvement of physical disability after failure of conservative management for 6 months. A variety of surgical techniques are available for management of this condition. We present our experience with conventional laminectomy, decompressive laminectomy with fixation and microscopic laminotomy via unilateral approach as 3 different surgical options regarding patients’ outcomes and complications. Methods: This is a retrospective study of patients with lumbar spinal stenosis operated in our institute in the period from January 2018 to December 2019. We included 69 adult patients and were subdivided into 3 groups according to the intervention done, either Lumbar decompression and fixation (group A) or conventional laminectomy (group B) or microscopic decompression (group C). Postoperative Disability changes via ODI, Back pain and leg pain via VAS were compared in the three groups. Results: Patient’s pain and disability significantly improved in all patients of the 3 groups. There was no significant difference in patients’ leg pain improvement compared in the 3 groups. Patients in the fixation group had significant back pain improvement (median improvement of 6) in comparison to both other groups (median improvement of 3 and 3). Patients in fixation groups had more amount of blood loss (median of 200 ml) and longer operative time (median of 180 minutes) compared to both other groups however this was not statistically significant. Conclusion: Conventional decompressive laminectomy with or without fixation and microscopic decompression would provide sufficient pain and disability improvement for patients with lumbar spinal stenosis. Further research is recommended to conclude evidence in favor of specific surgical technique. We suggest a significant improvement in postoperative back pain for patients with lumbar spinal stenosis receiving decompression and fixation in comparison to those who receive conventional laminectomy or microscopic decompressive laminotomy.

Published in	International Journal of Neurosurgery (Volume 6, Issue 2)
DOI	10.11648/j.ijn.20220602.17
Page(s)	67-76
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Lumbar Spinal Stenosis, Lumbar Canal Stenosis, Minimal Invasive Spine Surgery, Lumbar Decompression and Fixation

References

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APA Style

Ahmed Nagaty, Hesham Radwan, Mohamed Helmy Abd Elshafouk, Ahmad Elsabaa. (2022). Outcomes of Surgical Decompression Approaches in Patients with Lumbar Spinal Stenosis: Conventional VS Minimal Invasive VS Addition of Fixation. International Journal of Neurosurgery, 6(2), 67-76. https://doi.org/10.11648/j.ijn.20220602.17

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ACS Style

Ahmed Nagaty; Hesham Radwan; Mohamed Helmy Abd Elshafouk; Ahmad Elsabaa. Outcomes of Surgical Decompression Approaches in Patients with Lumbar Spinal Stenosis: Conventional VS Minimal Invasive VS Addition of Fixation. Int. J. Neurosurg. 2022, 6(2), 67-76. doi: 10.11648/j.ijn.20220602.17

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AMA Style

Ahmed Nagaty, Hesham Radwan, Mohamed Helmy Abd Elshafouk, Ahmad Elsabaa. Outcomes of Surgical Decompression Approaches in Patients with Lumbar Spinal Stenosis: Conventional VS Minimal Invasive VS Addition of Fixation. Int J Neurosurg. 2022;6(2):67-76. doi: 10.11648/j.ijn.20220602.17

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@article{10.11648/j.ijn.20220602.17,
  author = {Ahmed Nagaty and Hesham Radwan and Mohamed Helmy Abd Elshafouk and Ahmad Elsabaa},
  title = {Outcomes of Surgical Decompression Approaches in Patients with Lumbar Spinal Stenosis: Conventional VS Minimal Invasive VS Addition of Fixation},
  journal = {International Journal of Neurosurgery},
  volume = {6},
  number = {2},
  pages = {67-76},
  doi = {10.11648/j.ijn.20220602.17},
  url = {https://doi.org/10.11648/j.ijn.20220602.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20220602.17},
  abstract = {Background: Lumbar spinal stenosis is one of the commonest causes of patients’ disability due to degenerative disorders. Surgery have been found to be a more effective in relieve of patients’ symptoms and improvement of physical disability after failure of conservative management for 6 months. A variety of surgical techniques are available for management of this condition. We present our experience with conventional laminectomy, decompressive laminectomy with fixation and microscopic laminotomy via unilateral approach as 3 different surgical options regarding patients’ outcomes and complications. Methods: This is a retrospective study of patients with lumbar spinal stenosis operated in our institute in the period from January 2018 to December 2019. We included 69 adult patients and were subdivided into 3 groups according to the intervention done, either Lumbar decompression and fixation (group A) or conventional laminectomy (group B) or microscopic decompression (group C). Postoperative Disability changes via ODI, Back pain and leg pain via VAS were compared in the three groups. Results: Patient’s pain and disability significantly improved in all patients of the 3 groups. There was no significant difference in patients’ leg pain improvement compared in the 3 groups. Patients in the fixation group had significant back pain improvement (median improvement of 6) in comparison to both other groups (median improvement of 3 and 3). Patients in fixation groups had more amount of blood loss (median of 200 ml) and longer operative time (median of 180 minutes) compared to both other groups however this was not statistically significant. Conclusion: Conventional decompressive laminectomy with or without fixation and microscopic decompression would provide sufficient pain and disability improvement for patients with lumbar spinal stenosis. Further research is recommended to conclude evidence in favor of specific surgical technique. We suggest a significant improvement in postoperative back pain for patients with lumbar spinal stenosis receiving decompression and fixation in comparison to those who receive conventional laminectomy or microscopic decompressive laminotomy.},
 year = {2022}
}

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TY  - JOUR
T1  - Outcomes of Surgical Decompression Approaches in Patients with Lumbar Spinal Stenosis: Conventional VS Minimal Invasive VS Addition of Fixation
AU  - Ahmed Nagaty
AU  - Hesham Radwan
AU  - Mohamed Helmy Abd Elshafouk
AU  - Ahmad Elsabaa
Y1  - 2022/10/11
PY  - 2022
N1  - https://doi.org/10.11648/j.ijn.20220602.17
DO  - 10.11648/j.ijn.20220602.17
T2  - International Journal of Neurosurgery
JF  - International Journal of Neurosurgery
JO  - International Journal of Neurosurgery
SP  - 67
EP  - 76
PB  - Science Publishing Group
SN  - 2640-1959
UR  - https://doi.org/10.11648/j.ijn.20220602.17
AB  - Background: Lumbar spinal stenosis is one of the commonest causes of patients’ disability due to degenerative disorders. Surgery have been found to be a more effective in relieve of patients’ symptoms and improvement of physical disability after failure of conservative management for 6 months. A variety of surgical techniques are available for management of this condition. We present our experience with conventional laminectomy, decompressive laminectomy with fixation and microscopic laminotomy via unilateral approach as 3 different surgical options regarding patients’ outcomes and complications. Methods: This is a retrospective study of patients with lumbar spinal stenosis operated in our institute in the period from January 2018 to December 2019. We included 69 adult patients and were subdivided into 3 groups according to the intervention done, either Lumbar decompression and fixation (group A) or conventional laminectomy (group B) or microscopic decompression (group C). Postoperative Disability changes via ODI, Back pain and leg pain via VAS were compared in the three groups. Results: Patient’s pain and disability significantly improved in all patients of the 3 groups. There was no significant difference in patients’ leg pain improvement compared in the 3 groups. Patients in the fixation group had significant back pain improvement (median improvement of 6) in comparison to both other groups (median improvement of 3 and 3). Patients in fixation groups had more amount of blood loss (median of 200 ml) and longer operative time (median of 180 minutes) compared to both other groups however this was not statistically significant. Conclusion: Conventional decompressive laminectomy with or without fixation and microscopic decompression would provide sufficient pain and disability improvement for patients with lumbar spinal stenosis. Further research is recommended to conclude evidence in favor of specific surgical technique. We suggest a significant improvement in postoperative back pain for patients with lumbar spinal stenosis receiving decompression and fixation in comparison to those who receive conventional laminectomy or microscopic decompressive laminotomy.
VL  - 6
IS  - 2
ER  -

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Author Information

Ahmed Nagaty

Department of Neurosurgery, Ain Shams University, Cairo, Egypt
Hesham Radwan

Department of Neurosurgery, Ain Shams University, Cairo, Egypt
Mohamed Helmy Abd Elshafouk

Department of Neurosurgery, Ain Shams University, Cairo, Egypt
Ahmad Elsabaa

Department of Neurosurgery, Ain Shams University, Cairo, Egypt

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Ahmed Nagaty, Hesham Radwan, Mohamed Helmy Abd Elshafouk, Ahmad Elsabaa. (2022). Outcomes of Surgical Decompression Approaches in Patients with Lumbar Spinal Stenosis: Conventional VS Minimal Invasive VS Addition of Fixation. International Journal of Neurosurgery, 6(2), 67-76. https://doi.org/10.11648/j.ijn.20220602.17

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ACS Style

Ahmed Nagaty; Hesham Radwan; Mohamed Helmy Abd Elshafouk; Ahmad Elsabaa. Outcomes of Surgical Decompression Approaches in Patients with Lumbar Spinal Stenosis: Conventional VS Minimal Invasive VS Addition of Fixation. Int. J. Neurosurg. 2022, 6(2), 67-76. doi: 10.11648/j.ijn.20220602.17

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AMA Style

Ahmed Nagaty, Hesham Radwan, Mohamed Helmy Abd Elshafouk, Ahmad Elsabaa. Outcomes of Surgical Decompression Approaches in Patients with Lumbar Spinal Stenosis: Conventional VS Minimal Invasive VS Addition of Fixation. Int J Neurosurg. 2022;6(2):67-76. doi: 10.11648/j.ijn.20220602.17

Copy | Download

@article{10.11648/j.ijn.20220602.17,
  author = {Ahmed Nagaty and Hesham Radwan and Mohamed Helmy Abd Elshafouk and Ahmad Elsabaa},
  title = {Outcomes of Surgical Decompression Approaches in Patients with Lumbar Spinal Stenosis: Conventional VS Minimal Invasive VS Addition of Fixation},
  journal = {International Journal of Neurosurgery},
  volume = {6},
  number = {2},
  pages = {67-76},
  doi = {10.11648/j.ijn.20220602.17},
  url = {https://doi.org/10.11648/j.ijn.20220602.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20220602.17},
  abstract = {Background: Lumbar spinal stenosis is one of the commonest causes of patients’ disability due to degenerative disorders. Surgery have been found to be a more effective in relieve of patients’ symptoms and improvement of physical disability after failure of conservative management for 6 months. A variety of surgical techniques are available for management of this condition. We present our experience with conventional laminectomy, decompressive laminectomy with fixation and microscopic laminotomy via unilateral approach as 3 different surgical options regarding patients’ outcomes and complications. Methods: This is a retrospective study of patients with lumbar spinal stenosis operated in our institute in the period from January 2018 to December 2019. We included 69 adult patients and were subdivided into 3 groups according to the intervention done, either Lumbar decompression and fixation (group A) or conventional laminectomy (group B) or microscopic decompression (group C). Postoperative Disability changes via ODI, Back pain and leg pain via VAS were compared in the three groups. Results: Patient’s pain and disability significantly improved in all patients of the 3 groups. There was no significant difference in patients’ leg pain improvement compared in the 3 groups. Patients in the fixation group had significant back pain improvement (median improvement of 6) in comparison to both other groups (median improvement of 3 and 3). Patients in fixation groups had more amount of blood loss (median of 200 ml) and longer operative time (median of 180 minutes) compared to both other groups however this was not statistically significant. Conclusion: Conventional decompressive laminectomy with or without fixation and microscopic decompression would provide sufficient pain and disability improvement for patients with lumbar spinal stenosis. Further research is recommended to conclude evidence in favor of specific surgical technique. We suggest a significant improvement in postoperative back pain for patients with lumbar spinal stenosis receiving decompression and fixation in comparison to those who receive conventional laminectomy or microscopic decompressive laminotomy.},
 year = {2022}
}

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TY  - JOUR
T1  - Outcomes of Surgical Decompression Approaches in Patients with Lumbar Spinal Stenosis: Conventional VS Minimal Invasive VS Addition of Fixation
AU  - Ahmed Nagaty
AU  - Hesham Radwan
AU  - Mohamed Helmy Abd Elshafouk
AU  - Ahmad Elsabaa
Y1  - 2022/10/11
PY  - 2022
N1  - https://doi.org/10.11648/j.ijn.20220602.17
DO  - 10.11648/j.ijn.20220602.17
T2  - International Journal of Neurosurgery
JF  - International Journal of Neurosurgery
JO  - International Journal of Neurosurgery
SP  - 67
EP  - 76
PB  - Science Publishing Group
SN  - 2640-1959
UR  - https://doi.org/10.11648/j.ijn.20220602.17
AB  - Background: Lumbar spinal stenosis is one of the commonest causes of patients’ disability due to degenerative disorders. Surgery have been found to be a more effective in relieve of patients’ symptoms and improvement of physical disability after failure of conservative management for 6 months. A variety of surgical techniques are available for management of this condition. We present our experience with conventional laminectomy, decompressive laminectomy with fixation and microscopic laminotomy via unilateral approach as 3 different surgical options regarding patients’ outcomes and complications. Methods: This is a retrospective study of patients with lumbar spinal stenosis operated in our institute in the period from January 2018 to December 2019. We included 69 adult patients and were subdivided into 3 groups according to the intervention done, either Lumbar decompression and fixation (group A) or conventional laminectomy (group B) or microscopic decompression (group C). Postoperative Disability changes via ODI, Back pain and leg pain via VAS were compared in the three groups. Results: Patient’s pain and disability significantly improved in all patients of the 3 groups. There was no significant difference in patients’ leg pain improvement compared in the 3 groups. Patients in the fixation group had significant back pain improvement (median improvement of 6) in comparison to both other groups (median improvement of 3 and 3). Patients in fixation groups had more amount of blood loss (median of 200 ml) and longer operative time (median of 180 minutes) compared to both other groups however this was not statistically significant. Conclusion: Conventional decompressive laminectomy with or without fixation and microscopic decompression would provide sufficient pain and disability improvement for patients with lumbar spinal stenosis. Further research is recommended to conclude evidence in favor of specific surgical technique. We suggest a significant improvement in postoperative back pain for patients with lumbar spinal stenosis receiving decompression and fixation in comparison to those who receive conventional laminectomy or microscopic decompressive laminotomy.
VL  - 6
IS  - 2
ER  -

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