Lumbar Spinal Stenosis: Ipsilateral Facet-sparing Unilateral Laminotomy for Bilateral Decompression: Technical Note and Preliminary Results
Microsurgical unilateral laminotomy for bilateral decompression (ULBD) decompresses effectively lumbar stenosis. Whenever low grade degenerative spondylolisthesis, sagittal oriented facet joints, scoliotic deformity, tall disc, and obesity jeopardize postoperative segmental stability, a maximum face...
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| Format: | Article |
| Language: | English |
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Korean Minimally Invasive Spine Surgery Society
2021-10-01
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| Series: | Journal of Minimally Invasive Spine Surgery and Technique |
| Subjects: | |
| Online Access: | http://www.jmisst.org/upload/pdf/jmisst-2021-00255.pdf |
| _version_ | 1797951546943602688 |
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| author | Luca Papavero Kathrin Schawjinski Nawar Ali Justus Oehm Markus Pietrek Karsten Schoeller |
| author_facet | Luca Papavero Kathrin Schawjinski Nawar Ali Justus Oehm Markus Pietrek Karsten Schoeller |
| author_sort | Luca Papavero |
| collection | DOAJ |
| description | Microsurgical unilateral laminotomy for bilateral decompression (ULBD) decompresses effectively lumbar stenosis. Whenever low grade degenerative spondylolisthesis, sagittal oriented facet joints, scoliotic deformity, tall disc, and obesity jeopardize postoperative segmental stability, a maximum facet-preserving decompression is desirable. The medialized ULBD (mULBD) aims to preserve the facet joint on the approach side. Sixty-four patients presenting with neurogenic claudication underwent single or multilevel decompression with ULBD or mULBD according to the judgement of the surgeon. The volume of the target facet joints and the dural cross sectional area (CT-DCSA) were measured pre- and postoperatively by an ultra-low-dose CT with a specific software. Forty-three pairs of facet joints were addressed with ULBD and 43 pairs with mULBD. Postoperatively, the mean percentage of the preoperative facet joint volume preserved on the approach side was 70% ± 4% (ULBD) and 88% ± 6% (mULBD); (p<0.001). The mean facet joint volume preserved contraleral to the approach side was 87% ± 6% (ULBD) and 91% ± 6% (mULBD); (p=0.4). The mean postoperative CT-DCSA was 152 ± 30 mm² (ULBD) and 153 ± 26 mm² (mULBD); (p=0.43). The mUBLD decompresses lumbar spinal stenosis effectively as ULBD and preserves better the facet joint on the approach side. |
| first_indexed | 2024-04-10T22:32:18Z |
| format | Article |
| id | doaj.art-c8a369d352ac4aa6ad3c7c8ba10b3c02 |
| institution | Directory Open Access Journal |
| issn | 2508-2043 |
| language | English |
| last_indexed | 2024-04-10T22:32:18Z |
| publishDate | 2021-10-01 |
| publisher | Korean Minimally Invasive Spine Surgery Society |
| record_format | Article |
| series | Journal of Minimally Invasive Spine Surgery and Technique |
| spelling | doaj.art-c8a369d352ac4aa6ad3c7c8ba10b3c022023-01-17T04:35:08ZengKorean Minimally Invasive Spine Surgery SocietyJournal of Minimally Invasive Spine Surgery and Technique2508-20432021-10-016214715510.21182/jmisst.2021.00255119Lumbar Spinal Stenosis: Ipsilateral Facet-sparing Unilateral Laminotomy for Bilateral Decompression: Technical Note and Preliminary ResultsLuca Papavero0Kathrin Schawjinski1Nawar Ali2Justus Oehm3Markus Pietrek4Karsten Schoeller5 Clinic for Spine Surgery, Schoen Clinic Hamburg Eilbek, Hamburg, Germany Clinic for Spine Surgery, Schoen Clinic Hamburg Eilbek, Hamburg, Germany Clinic for Spine Surgery, Schoen Clinic Hamburg Eilbek, Hamburg, Germany Clinic for Spine Surgery, Schoen Clinic Hamburg Eilbek, Hamburg, Germany Clinic for Spine Surgery, Schoen Clinic Hamburg Eilbek, Hamburg, Germany Clinic for Spine Surgery, Schoen Clinic Hamburg Eilbek, Hamburg, GermanyMicrosurgical unilateral laminotomy for bilateral decompression (ULBD) decompresses effectively lumbar stenosis. Whenever low grade degenerative spondylolisthesis, sagittal oriented facet joints, scoliotic deformity, tall disc, and obesity jeopardize postoperative segmental stability, a maximum facet-preserving decompression is desirable. The medialized ULBD (mULBD) aims to preserve the facet joint on the approach side. Sixty-four patients presenting with neurogenic claudication underwent single or multilevel decompression with ULBD or mULBD according to the judgement of the surgeon. The volume of the target facet joints and the dural cross sectional area (CT-DCSA) were measured pre- and postoperatively by an ultra-low-dose CT with a specific software. Forty-three pairs of facet joints were addressed with ULBD and 43 pairs with mULBD. Postoperatively, the mean percentage of the preoperative facet joint volume preserved on the approach side was 70% ± 4% (ULBD) and 88% ± 6% (mULBD); (p<0.001). The mean facet joint volume preserved contraleral to the approach side was 87% ± 6% (ULBD) and 91% ± 6% (mULBD); (p=0.4). The mean postoperative CT-DCSA was 152 ± 30 mm² (ULBD) and 153 ± 26 mm² (mULBD); (p=0.43). The mUBLD decompresses lumbar spinal stenosis effectively as ULBD and preserves better the facet joint on the approach side.http://www.jmisst.org/upload/pdf/jmisst-2021-00255.pdfzygapophyseal jointspinal stenosisspinal canaldecompressionspondylolisthesis |
| spellingShingle | Luca Papavero Kathrin Schawjinski Nawar Ali Justus Oehm Markus Pietrek Karsten Schoeller Lumbar Spinal Stenosis: Ipsilateral Facet-sparing Unilateral Laminotomy for Bilateral Decompression: Technical Note and Preliminary Results Journal of Minimally Invasive Spine Surgery and Technique zygapophyseal joint spinal stenosis spinal canal decompression spondylolisthesis |
| title | Lumbar Spinal Stenosis: Ipsilateral Facet-sparing Unilateral Laminotomy for Bilateral Decompression: Technical Note and Preliminary Results |
| title_full | Lumbar Spinal Stenosis: Ipsilateral Facet-sparing Unilateral Laminotomy for Bilateral Decompression: Technical Note and Preliminary Results |
| title_fullStr | Lumbar Spinal Stenosis: Ipsilateral Facet-sparing Unilateral Laminotomy for Bilateral Decompression: Technical Note and Preliminary Results |
| title_full_unstemmed | Lumbar Spinal Stenosis: Ipsilateral Facet-sparing Unilateral Laminotomy for Bilateral Decompression: Technical Note and Preliminary Results |
| title_short | Lumbar Spinal Stenosis: Ipsilateral Facet-sparing Unilateral Laminotomy for Bilateral Decompression: Technical Note and Preliminary Results |
| title_sort | lumbar spinal stenosis ipsilateral facet sparing unilateral laminotomy for bilateral decompression technical note and preliminary results |
| topic | zygapophyseal joint spinal stenosis spinal canal decompression spondylolisthesis |
| url | http://www.jmisst.org/upload/pdf/jmisst-2021-00255.pdf |
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