بررسي نتايج عمل جراحي لامينوتومي در بيماران مبتلا به تنگي كانال نخاعي كمري

Results of Laminotomy in Lumbar Canal Stenosis

Background: Spinal Canal Stenosis is a common lumbar spine problem above age 65. The resultant low back pain due to degenerative change is a principle cause of workman compensation claims. To stop the insidious progression and disabling outcome early diagnosis and treatment is warranted. Materials and Methods: We carried out a retrospective review of 60 patients with lumbar spinal canal stenosis who had been treated surgically with undercutting fenestration laminotomy, and had been followed regularly. 50 cases were evaluated at a mean of 3.5 years (1-9 years) after surgery. The outcome was assessed using the scoring system of Louise and rating system of Prolo. Instability was determined according to the criteria described by White and Panjabi. Results: A significant decrease in low back pain and disability was seen. An excellent or good outcome was noted in 82% of patients, 6% showed secondary radiologic instability. Claudication disappeared in all patients and radicular pain was relieved in 94% of patients. Conclusion: Thus undercutting fenestration laminotomy is a safe and efficient procedure. When instability is suspected, instrumented fusion is recommended.