• Spine · Nov 2021

    Wide Laminectomy, Segmental Bilateral Laminotomies, or Unilateral Hemi-Laminectomy for Lumbar Spinal Stenosis: Five-year Patient-reported Outcomes in Propensity-matched Cohorts.

    • Jamal Bech Bouknaitir, Leah Y Carreon, Stig Brorson, Casper Friis Pedersen, and Mikkel Østerheden Andersen.
    • Spine Unit, Department of Orthopedic Surgery, Zealand University Hospital, Koege, Denmark.
    • Spine. 2021 Nov 1; 46 (21): 1509-1515.

    Study DesignPropensity-matched retrospective study of patients prospectively enrolled in Danespine.ObjectiveThe aim of this study was to report 5-year patient reported outcome in lumbar spinal stenosis (LSS) patients who underwent wide laminectomy (WL), segmental bilateral laminotomies (SBL), or unilateral hemilaminectomy (UHL) with bilateral decompression.Summary Of Background DataThe optimal procedure for LSS remains controversial. Studies have shown no difference in short term outcomes among micro-laminectomy, hemi-laminotomies, broad laminectomy, and laminectomy with instrumented fusion.MethodsPatients with spinal stenosis who were enrolled in DaneSpine at two spine centers from January 2010 until May 2014 and underwent WL0, SBL, or UHL with bilateral decompression were identified. Patients completed standard questionnaires preoperatively and 1, 2, and 5 years after surgery. Patients in the three cohorts were propensity-matched using age, sex, body mass index (BMI), smoking status, number of surgical levels, American Society of Anesthesiologists (ASA) score, and patient-reported outcome measures (PROMs).ResultsPropensity matching produced 62 cases in each group. There were no differences in PROM among the three cohorts at five years follow up. Twelve patients were re-operated at the index level. The most frequent indication of reoperation was repeat decompression after SBL. Regression analysis revealed no statistical significant associations between the incidence of reoperation and age, sex, number of operated levels, ASA score, BMI, center, smoking status, or having a dural tear at index operation.ConclusionThis study revealed no significant difference PROMs, reoperation rates or time to reoperation at five years follow up between SBLs, UHL, or WL in patients operated for central LSS.Level of Evidence: 4.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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