Document Detail


The surgical treatment of central lumbar stenosis. Multiple laminotomy compared with total laminectomy.
MedLine Citation:
PMID:  8496205     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We assigned 67 patients with central lumbar stenosis alternately to either multiple laminotomy or total laminectomy. The protocol, however, allowed multiple laminotomy to be changed to total laminectomy if it was thought that the former procedure might not give adequate neural decompression. There were therefore three treatment groups: group I consisting of 26 patients submitted to multiple laminotomy; group II, 9 patients scheduled for laminotomy but submitted to laminectomy; and group III, 32 patients scheduled for, and submitted to, laminectomy. The mean follow-up was 3.7 years. Bilateral laminotomy at two or three levels required a longer mean operating time than total laminectomy at an equal number of levels. The mean blood loss at surgery and the clinical results did not differ in the three groups. The mean subjective improvement score for low back pain was higher in group I but there was also a higher incidence of neural complications in this group. No patient in group I had postoperative vertebral instability, whereas this occurred in three patients in groups II and III, who had lumbar scoliosis or degenerative spondylolisthesis preoperatively. Multiple laminotomy is recommended for all patients with developmental stenosis and for those with mild to moderate degenerative stenosis or degenerative spondylolisthesis. Total laminectomy is to be preferred for patients with severe degenerative stenosis or marked degenerative spondylolisthesis.
Authors:
F Postacchini; G Cinotti; D Perugia; S Gumina
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  The Journal of bone and joint surgery. British volume     Volume:  75     ISSN:  0301-620X     ISO Abbreviation:  J Bone Joint Surg Br     Publication Date:  1993 May 
Date Detail:
Created Date:  1993-06-22     Completed Date:  1993-06-22     Revised Date:  2010-11-10    
Medline Journal Info:
Nlm Unique ID:  0375355     Medline TA:  J Bone Joint Surg Br     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  386-92     Citation Subset:  AIM; IM    
Affiliation:
University of Modena, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Loss, Surgical / statistics & numerical data
Female
Follow-Up Studies
Humans
Incidence
Intraoperative Period
Laminectomy / methods,  standards*
Lumbosacral Region
Magnetic Resonance Imaging
Male
Middle Aged
Myelography
Postoperative Complications / epidemiology,  etiology
Severity of Illness Index
Spinal Stenosis / classification,  radiography,  surgery*
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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