Long-Term Clinical Outcome and Reoperation Rate for Microsurgical Bilateral Decompression via Unilateral Approach of Lumbar Spinal Stenosis

• Published in: World neurosurgery 2019-05, Vol.125, p.e465-e472
• Main Authors: Yüce, İsmail, Kahyaoğlu, Okan, Çavuşoğlu, Halit Arda, Çavuşoğlu, Halit, Aydın, Yunus
• Format: Article
• Language: English
• Subjects: Adult; Aged; Bilateral decompression; Decompression, Surgical - methods; Disability Evaluation; Female; Humans; Lumbar spinal stenosis; Lumbar Vertebrae - surgery; Lumbosacral Region - surgery; Male; Microdiscectomy; Middle Aged; Neurosurgical Procedures; Prospective Studies; Reoperation rate; Spinal Stenosis - surgery; Time; Treatment Outcome; Unilateral approach
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2019.01.105

To evaluate long-term outcome and reoperation rate for microsurgical bilateral decompression via unilateral approach of lumbar spinal stenosis, a common degenerative spinal disease of the lumbar spine. In this observational prospective study, 918 patients were treated for single-level or multilevel lumbar spinal stenosis by bilateral decompression via unilateral approach between January 2002 and January 2016. Of 918 patients, 180 underwent microdiscectomy with decompression. Follow-up consisted of radiologic investigations, Oswestry Disability Index questionnaire, and 36-Item Short-Form Health Survey at 6 and 12 months postoperatively. There were 492 female patients (53.6%) and 426 male patients (46.4%) with a mean age of 63.83 ± 10.16 years (range, 43–79 years). Symptom duration was 4–49 months. Average follow-up time was 98 months (range, 25–168 months), and reoperation rate was 2.5%. Oswestry Disability Index scores decreased significantly (from 30.65 ± 7.82 to 11.32 ± 2.50 at 6 months and 11.30 ± 2.49 at 12 months), and 36-Item Short-Form Health Survey parameter scores demonstrated a significant improvement in the early and late follow-up results. Bilateral decompression via unilateral approach for lumbar spinal stenosis allowed a sufficient and safe decompression of the neural structures, resulting in a highly significant reduction of symptoms and disability, acceptable reoperation rate, and improved health-related quality of life.