• Paria Shafiekhani, Melika Hajimohammadebrahim-Ketabforoush, Elnaz Amanzadeh Jajin, Sara Zandpazandi, and Mohammadreza Shahmohammadi.
• Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
• World Neurosurg. 2024 Jul 1; 187: e257e263e257-e263.

BackgroundIn patients with simultaneous lumbar central spinal stenosis (LCSS) and lateral recess stenosis (LRS) at multiple levels, spinal decompression using microscopic bilateral laminotomy was compared to total laminectomy plus medial facetectomy and fusion (LF).MethodsFrom 2017 to 2022, this trial was performed to examine 96 patients with concomitant LCS and LRS at multilevel. Of the 96 patients, 48 were allocated to the following groups: LF (group I) or microscopic bilateral laminotomy (group II). However, 76 patients completed the study. We compared the outcomes in these 2 groups.ResultsMicroscopic bilateral laminotomy was superior in most outcome measures. Delta-visual analog scale leg pain in group II was significantly greater than in group I (mean-group I: 4.368 vs. group II: 5.368, P value = 0.001). Complication and revision rates were lower in the microscopic bilateral laminotomy than in group I, except for incidental durotomy occurrence (group II: 31.58% -group I: 7.89%, P value = 0.0190). The rate of revision surgery for group I compared with group II was 44.74% versus 13.16% (P value = 0.0047), indicating the superiority of laminotomy over LF. The mean length of hospital stay was 3.551 ± 0.6349 in group II versus 6.774 ± 1.197 in group I (P value <0.0001). Also, blood loss during surgery was significantly lower in group II (P value <0.0001).ConclusionsThe findings indicate that microscopic bilateral laminotomy provides favorable clinical and radiological outcomes for individuals experiencing multilevel lumbar central canal and LRS. However, a higher frequency of durotomy may occur during microsurgical procedures.Copyright © 2024 Elsevier Inc. All rights reserved.

27 keywords...

hide…