Microdecompressive laminatomy with a 5-year follow-up period for severe lumbar spinal stenosis

Study Design: The 2 groups of patients with severe lumbar spinal stenosis were prospectively compared as a case control study. Objectives: This prospective case control study sought to evaluate bilateral microdecompressive laminatomy (MDL) for treatment of severe lumbar spinal stenosis. Summary of Background Data: Total laminectomy is a general consensus on the therapy of severe spinal stenosis. The authors tried to investigate a new minimal invasive approach. Methods: Patients were randomly divided into 2 groups. In first group, 34 patients underwent total laminectomy (TL) for severe lumbar spinal stenosis. In the second group, 37 patients with the same diagnosis underwent bilateral MDL. The groups were compared for disability, walking distance, degree of postoperative back and leg pain, perioperative complications, and postoperative instability. Radiographic analyses were performed at regular intervals to demonstrate satisfactory decompression. Results: Mean follow-up was 5 years. Postoperative computerized tomography and magnetic resonance imaging demonstrated adequate decompressions in both groups. The walking distance, pain control, and disability scores were slightly higher among patients in the MDL group, although these results did not achieve statistical significance. Perioperative complications and postoperative instability were significantly higher in the TL group (P<0.05). Conclusions: Compared with classic approaches, bilateral MDL provides adequate and safe decompression in lumbar spinal stenosis. It significantly reduces clinical symptoms and disability. However, TL shows higher perioperative complications and postoperative instability. To the best of our knowledge, this is the first study to define a bilateral MDL approach to treat the stenotic lumbar spine without a herniated disc. © 2010 by Lippincott Williams & Wilkins.