ABSTRACT

A variety of techniques have been used for the treatment of degenerative lumbar spinal stenosis (DLSS). For most patients, the clinical outcomes are adversely affected by concomitant systemic diseases and destabilizing decompressive surgical approaches. Here, we present cases treated with lumbar decompression by unilateral laminotomy. A retrospective study was conducted of data obtained in a consecutive series of 18 patients treated with bilateral decompression by a unilateral laminotomy technique for DLSS over a three-year period (2009–2011). The preoperative and postoperative clinical and radiological evaluations were compared. One patient died due to myocardial infarction, and regular follow-up could only be achieved for 12 of the remaining 17 patients, eight women and four men. The mean follow-up period was 18.9 months and the mean age was 62 (52–76) years. The preoperative and postoperative mean AP diameter of the spinal canal was 8.26 (5–11) mm and 16.58 (10–30) mm, respectively (p≤0.05), the preoperative and postoperative transverse diameter was 6.69 (5–7.5) mm and 10.2 (8–14) mm, respectively (p≤0.05), and the preoperative and postoperative mean width of the facet joint gap was 3.18 (2–4) mm and 3.11 (2–4) mm, respectively (p≥0.05). The preoperative VAS score was 8.41 (7–10), and the Prolo functional score was 2 and the economic score was 2.6, while the postoperative values were 3.91 (0–8) (p≤0.05), 3.58 (p≤0.05), and 4.8 (p≤0.05), respectively. None of the patients required secondary surgery. During the restabilization period of the degenerative process, the unilateral laminotomy technique provided adequate canal decompression and achieved good clinical outcomes. With this surgical technique, the preservation of vertebral stability avoids the complications associated with the more aggressive implantation procedures.