Clin Orthop Surg.
2020 Dec;12(4):493-502. 10.4055/cios19176.
Decompressive Laminectomy Alone for Degenerative Lumbar Scoliosis with Spinal Stenosis: Incidence of Post-Laminectomy Instability in the Elderly
- Affiliations
-
- 1Department of Orthopaedic Surgery, Spine Center, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
- 2Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 3Department of Orthopaedic Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- KMID: 2508780
- DOI: http://doi.org/10.4055/cios19176
Abstract
- Background
Decompressive laminectomy alone for degenerative lumbar scoliosis (DLS) is not recommended because it can lead to further instability. However, it is uncertain whether instability at the decompressed segments is directly affected by laminectomy or the natural progression of DLS. The purpose of this study was to evaluate the surgical outcome of decompressive laminectomy alone for DLS with spinal stenosis and to determine whether the procedure leads to post-laminectomy instability (PLI).
Methods
We retrospectively reviewed 60 patients with DLS. They were divided into 2 groups according to PLI criteria: stable group and PLI group. The PLI group was subdivided into 2 groups based on the level of PLI: the first group that showed PLI at the index laminectomy level (PLI-I) and the second group that showed PLI at another level other than the laminectomy level (PLI-NI). Radiological evaluation was performed to determine factors associated with the progression of DLS. Pain and disability outcomes were assessed.
Results
There were 34 patients (56.7%) in the stable group and 26 patients (43.3%) in the PLI group. Twelve patients (20.0%) underwent revision surgery. Eleven patients (18.3%) showed PLI at the index segments (PLI-I group), and 15 patients (25%) showed PLI at the adjacent or cephalad segments, not related to the laminectomy site (PLI-NI group). Four patients underwent revision surgery in the stable group and 8 in the PLI group. Survivorship analyses revealed that the predicted survivorship of DLS was 90.0% at 12 months and 86.4% at 24 months after laminectomy.
Conclusions
The development of PLI was not always related to laminectomy at the index level. However, PLI developed more rapidly at the index level, compared to the natural progression of the scoliotic curve at the adjacent segments.
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Transpedicular Screw instrumentation and Spinal Fusion after Laminectomy in Lumbar Spinal Stenosis
- Clinical Analysis of Less Extensive Microsurgical Decompression for Lumbar Spinal Stenosis
- Surgical Treatment of Degenerative Lumbar Scoliosis with Multiple Spinal Stenosis
- A Comparison of Clinical Outcomes between Decompressive Lumbar Laminectomy Alone and with Arthrodesis in Degenerative Lumbar Spinal Stenosis
- A Comparison of Clinical Outcomes between Decompressive Laminectomy Alone and with Arthrodesis in Lumbar Single Level Spinal Stenosis
