Intradiscal pressure and kinematic behavior of lumbar spine after bilateral laminotomy and laminectomy

Background context: Bilateral laminotomy has been proposed as an alternative to laminectomy for decompression of lumbar spinal stenosis. Preservation of the posterior midline ligaments with laminotomy is presumed to maintain spinal segment stability. There have been no previous studies that directly...

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Bibliographic Details
Published in:The spine journal 2002-09, Vol.2 (5), p.320-326
Main Authors: Rao, Raj D, Wang, Mei, Singhal, Peeush, McGrady, Linda M, Rao, Santi
Format: Article
Language:English
Subjects:
Animals
Biomechanical Phenomena
Cadaver
Cattle
Decompression, Surgical - methods
Disc stress
Intervertebral Disc - physiology
Laminectomy - methods
Lumbar decompression
Lumbar Vertebrae - surgery
Pressure
Probability
Range of Motion, Articular - physiology
Reference Values
Sensitivity and Specificity
Spinal Stenosis - surgery
Spine - surgery
Stability
Stenosis
Stress, Mechanical
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Summary:Background context: Bilateral laminotomy has been proposed as an alternative to laminectomy for decompression of lumbar spinal stenosis. Preservation of the posterior midline ligaments with laminotomy is presumed to maintain spinal segment stability. There have been no previous studies that directly compare the amount of destabilization and increase in disc pressures between the two procedures. Purpose: To quantify spinal segmental instability caused by bilateral laminotomy and laminectomy, and to compare the central and peripheral intradiscal pressures after the two procedures. Study design/setting: Mechanical testing of the lumbar motion segments of calf spines. Methods: Nine fresh calf spines were tested under flexion, extension, lateral bending and axial rotation, intact first, then after laminotomy and laminectomy at the level of L4–L5. Four miniature pressure transducers were implanted in the central and peripheral disc at L4–L5 to measure intradiscal pressures. Three-dimensional motion was measured with motion analysis system. Results: Comparing with bilateral laminotomy, laminectomy showed significant increase in segmental motion at the surgical level in flexion (16%, p
ISSN:1529-9430
1878-1632
DOI:10.1016/S1529-9430(02)00402-3