Journal of Korean Neurosurgical Society

  • 제58권1호
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  • Pages.65-71
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  • 2015
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Limited Unilateral Decompression and Pedicle Screw Fixation with Fusion for Lumbar Spinal Stenosis with Unilateral Radiculopathy : A Retrospective Analysis of 25 Cases

  • Zhang, Li (Department of Orthopedic Surgery, Peking University Third Hospital) ;
  • Miao, Hai-xiong (Department of Orthopedic Surgery, Huizhou First Hospital) ;
  • Wang, Yong (Department of Surgery, Beijing North Hospital of Ordnance Industry) ;
  • Chen, An-fu (Department of Surgery, Beijing North Hospital of Ordnance Industry) ;
  • Zhang, Tao (Department of Orthopedic Surgery, General Hospital of Huabei Oil Field Company) ;
  • Liu, Xiao-guang (Department of Orthopedic Surgery, Peking University Third Hospital)
  • 투고 : 2014.08.29
  • 심사 : 2014.12.30
  • 발행 : 2015.07.28
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초록

Objective : Lumbar spinal stenosis is conventionally treated with surgical decompression. However, bilateral decompression and laminectomy is more invasive and may not be necessary for lumbar stenosis patients with unilateral radiculopathy. We aimed to report the outcomes of unilateral laminectomy and bilateral pedicle screw fixation with fusion for patients with lumbar spinal stenosis and unilateral radiculopathy. Methods : Patients with lumbar spinal stenosis with unilateral lower extremity radiculopathy who received limited unilateral decompression and bilateral pedicle screw fixation were included and evaluated using visual analog scale (VAS) pain and the Oswestry Disability Index (ODI) scores preoperatively and at follow-up visits. Ligamentum flavum thickness of the involved segments was measured on axial magnetic resonance images. Results : Twenty-five patients were included. The mean preoperative VAS score was $6.6{\pm}1.6$ and $4.6{\pm}3.1$ for leg and back pain, respectively. Ligamentum flavum thickness was comparable between the symptomatic and asymptomatic side (p=0.554). The mean follow-up duration was 29.2 months. The pain in the symptomatic side lower extremity (VAS score, $1.32{\pm}1.2$) and the back (VAS score, $1.75{\pm}1.73$) significantly improved (p=0.000 vs. baseline for both). The ODI improved significantly postoperatively ($6.60{\pm}6.5$; p=0.000 vs. baseline). Significant improvement in VAS pain and ODI scores were observed in patients receiving single or multi-segment decompression fusion with fixation (p<0.01). Conclusion : Limited laminectomy and unilateral spinal decompression followed by bilateral pedicle screw fixation with fusion achieves satisfactory outcomes in patients with spinal stenosis and unilateral radiculopathy. This procedure is less damaging to structures that are important for maintaining posterior stability of the spine.

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참고문헌

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피인용 문헌

  1. Analysis of surgeries for Degenerative lumbarstenosis in elderly patients vol.32, pp.1, 2016, https://doi.org/10.12669/pjms.321.8917
  2. Clinical and Radiological Comparison between Ipsilateral and Contralateral Side Canal Decompression Using an Unilateral Laminotomy Approach vol.13, pp.2, 2016, https://doi.org/10.14245/kjs.2016.13.2.41