Radiological Outcomes of Unilateral Laminotomy for Bilateral Decompression in Lumbar Spinal Stenosis With and Without Discectomy

• Published in: World neurosurgery 2023-07, Vol.175, p.e1307-e1314
• Main Authors: Cho, Hyun-Seo, Kim, Se-Hoon, Han, Jeong Su, Kim, Bum-Joon
• Format: Article
• Language: English
• Subjects: Decompression, Surgical - methods; Discectomy; Diskectomy; Humans; Laminectomy; Laminectomy - methods; Lordosis - surgery; Lumbar spinal stenosis; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - surgery; Minimally invasive surgery; Retrospective Studies; Spinal Stenosis - complications; Spinal Stenosis - diagnostic imaging; Spinal Stenosis - surgery; Treatment Outcome; Unilateral laminotomy bilateral decompression
• ISSN: 1878-8750; 1878-8769; 1878-8769
• DOI: 10.1016/j.wneu.2023.04.124

Unilateral laminotomy for bilateral decompression (ULBD) is a minimally invasive surgical technique widely used in patients with lumbar spinal stenosis and low-grade spondylolisthesis. However, few studies have investigated the long-term effects of the unilateral approach of ULBD on postoperative coronal imbalance, and the effect of additional discectomy on ULBD has not yet been evaluated in detail. Sixty-one patients with lumbar spinal stenosis who underwent ULBD with or without discectomy were identified. The ULBD with discectomy group included 27 patients, and the ULBD without discectomy group included 34 patients. We analyzed the changes in various radiographic parameters, such as global lordosis (GL), segmental lordosis (SL), global coronal angle (GCA), segmental coronal angle (SCA), disc height (DH), global range of motion (GROM), and segmental range of motion (SROM) following the surgery and compared these parameters between the two groups. In patients who underwent ULBD with discectomy, segmental coronal angle (SCA) significantly decreased from 0.42 ± 4.41 (°±SD) preoperatively to −0.31 ± 4.87 postoperatively (P = 0.026), while disc height (DH) decreased from 8.80 ± 2.49 (mm ± SD) to 7.32 ± 2.60 (P