Korean J Spine.  2014 Dec;11(4):227-231. 10.14245/kjs.2014.11.4.227.

Postoperative Expansion of Dural Sac Cross-Sectional Area after Unilateral Laminotomy for Bilateral Decompression: Correlation with Clinical Symptoms

• Chung SW
• Kang MS
• Shin YH
• Baek OK
• Lee SH

• KMID: 1738747
• DOI: http://doi.org/10.14245/kjs.2014.11.4.227

Abstract

OBJECTIVE
Dural sac cross-sectional area (DSCSA) is a way to measure the degree of central spinal canal compression. The objective was to investigate the correlation between the expansion ratio of DSCSA after unilateral laminotomy for bilateral decompression (ULBD) and the clinical results for lumbar spinal stenosis.
METHODS
We retrospectively reviewed the clinical data and radiographs of 103 patients who underwent ULBD for symptomatic spinal stenosis in one year. We compared preoperative and postoperative clinical data and DSCSA and evaluated the correlation between clinical and radiographic measurements.
RESULTS
There was a significant increase of DSCSA after ULBD (p=0.000) and mean expansion ratio of DSCSA was 203.7+/-147.2%(range -32.9-826.1%). Clinical outcomes, measured by VAS and ODI were improved significantly not only in early postoperative period, but also in the last follow-up. However, there were no statistically significant correlations between the preoperative DSCSA and clinical symptoms, Perioperative expansion ratio of DSCSA and clinical parameters were also not correlated to the improvement of clinical symptoms significantly in both early postoperative phase and last follow-up.
CONCLUSION
Our result indicates that the DSCSA itself has a definite limitation to be correlated to the clinical symptoms, and thus meticulous correlation between the clinical presentation and MRI imaging is essential in determination of surgical treatment.

Keyword

Spinal stenosis; Minimally invasive spinal surgery; Laminotomy; Radiculopathy

MeSH Terms

Decompression*
Follow-Up Studies
Humans
Laminectomy*
Magnetic Resonance Imaging
Postoperative Period
Radiculopathy
Retrospective Studies
Spinal Canal
Spinal Stenosis