A comparation of efficacy between unilateral laminectomy approach bilateral decompression and traditional total laminectomy decompression in the treatment of lumbar spinal stenosis

Objectives To compare the efficacy between unilateral laminectomy approach bilateral decompression and traditional total laminectomy decompression in the treatment of graft bone fusion and internal fixation for degenerative lumbar spinal stenosis with the unilateral symptoms. Method From January 2013 to December 2014, a total of 40 patients with unilateral symptoms of lumbar spinal stenosis were treated in Department of Spinal Surgery Bozhou People's Hospital of Anhui Province. Twenty patients(group A ) were treated by severe symptoms unilateral facetectomy and resection of superior articular and laminectomy and lateral recess decompression, interbody fusion, pedicle screw fixation.Twenty patients(group B ) were treated by total laminectomy interbody fusion and pedicle screw fixation.The time of operation, blood loss of the two groups were recorded.At the same time the visual analog scale (VAS), Oswestry disability index(ODI), Japanese Orthopaedic Association Scores(JOA) before and after operation (3, 6 , 12months) were recorded retrospectively. The effect of surgery were evaluated and compared. Result The VAS, JOA, and ODI of group A preoperation is respectively have no significant differences with the group B (P>0.05). The operation time, blood loss in operation of group A was respectively(133.2±25.3) min, (415.0±42.1) ml, significant differences with the group B[(491.0±46.3)ml; (156.2±28.5) min, P 0.05) at 3, 6 months after operation.The VAS, JOA, ODI of group A was respectively (3.0±0.6), (25.3±5.1), (16.5±1.5)scores, had significant differences with the group B and preoperation (P<0.05) at 12 months after operation. The radiographic data showed that the interbody fusion rate of group A was 100%, and group B was 95%, had significant differences by statistical analysis (P<0.05) at 12 months afer operation. Conclusion The improved unilateral laminectomy approach and bilateral decompression have less operation time and blood loss, more satisfactory for the lumbar spinal stenosis patients with the unilateral severe symptoms, the other side moderate stenosis and mild symptoms.The efficacy of lumbar stability and bilateral decompression is better by operation of improved unilateral approach. Key words: Spinal stenosis; Lumbar vertebrae; Decompression, surgical