Minimally Invasive Laminectomy for Lumbar Spinal Stenosis in Patients with and without Preoperative Spondylolisthesis: Clinical Outcome and Reoperation Rate (original) (raw)

2014, Global Spine Journal

S ymptomatic lumbar spinal stenosis (LSS) unresponsive to conservative therapy is commonly treated using direct surgical decompression. 33 Current guidelines recommend additional arthrodesis in patients with LSS and preexisting spondylolisthesis. 21,24,31,49,50,52 Various techniques are currently used for direct decompression of LSS. Standard open laminectomy has been shown to be an effective procedure for LSS decompression. 36,46,54,60-64,66 However, wide laminectomies violating stabilizing bony and ligamentous structures may exacerbate preexisting spondylolisthesis. 19,37 Minimally invasive laminectomy through tubular or similar retractors is a recently introduced alternative procedure for decompression of LSS. 47 This technique avoids detachment of the paraspinal muscles and may promote preservation of stabilizing ligamentous and bony spinal structures. 29,30,39,41-45 Biomechanical studies indicate that compared with open laminectomy, minimally invasive laminectomy may result in less postoperative instability. 1,6,12,23,34 The current study had two main goals: first, to evaluate the efficacy of minimally invasive laminectomy as a decompressive procedure for the treatment of patients with abbreviatioNS BMI = body mass index; LSS = lumbar spinal stenosis; MCID = minimum clinically important difference; ODI = Oswestry Disability Index; VAS = visual analog scale. accompaNyiNg editorial See pp 337-338.