JHSM
Journal of Health Sciences and Medicine

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

ISSN: Active
eISSN: 2636-8579
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Submit Manuscript

Index
Original Article
Postlaminectomy instability–is fusion essential in degenerative lumbar stenosis surgery?
Abstract
Aim: To examine the incidence of postlaminectomy instability in cases of lumbar spinal stenosis who underwent facet- preserving laminectomy and decompression with the classical laminectomy technique, together with comorbid diseases, and to determine whether fusion is needed. Material and Method: The patients who were operated by the same surgeon in the same hospital between 2017 and 2019 and followed up in terms of instability in the postoperative 1st and 6th months were evaluated retrospectively with their clinical findings, comorbid diseases and radiological images. White and Panjabi's instability criteria were used. It was analyzed with SPSS 23.00 statistical package program. Data were analyzed by descriptive statistics (number, percentage distribution, mean and standard deviation), t-test and ANOV A. Results: A total of 53 patients, 22 male (41.5%) and 31 female (58.5%) were included in the study. Age, surgical precedures and comorbid diseases were investigated. None of the patients, but 2 patients with osteoporosis with or without diabets, had postlaminectomy instability. Conclusion: It has been shown in our study that decompressive and facet-preserving surgery performed at 2 levels or less using only the classical laminectomy technique does not cause instability in patients without osteoporosis alone or with diabetes, especially in the first 6 months, and can be safely applied to patients. Osteoporosis alone or in association with diabetes mellitus suggests increased postoperative instability.

Keywords : Decompression, laminectomy, spinal stenosis

Download Article


1. White AA, 3rd, Johnson RM, Panjabi MM, Southwick WO. Biomechanical analysis of clinical stability in the cervical spine. Clin Orthop Relat Res 1975; 109: 85–96.
2. White AA, Panjabi MM. Clinical biomechanics of the spine. 2. Philadelphia: Lippincott; 1990. pp. 23–45.
3. Mosenthal WP, Dickherber JL, Saitta BH, Lee MJ. Post laminectomy instability. Semin Spine Surg 2019; 31: 100713.
4. Resnick DK, Watters WC III, Sharan A, et al. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 9: lumbar fusion for stenosis with spondylolisthesis. J Neurosurg Spine 2014; 21: 54–61.
5. Lutz FS, Munhoz da Rocha LS. Post-Laminectomy Deformities. Coluna/Columna 2014; 13: 279-81.
6. Fox MW, Onofrio BM. Indications for fusion following decompression for lumbar spinal stenosis. Neurosurg Focus 1997; 3: e2.
7. Herkowitz HN, Kurz LT. Degenerative lumbar spondylolisthesis with spinal stenosis. A prospective study comparing decompression with decompression and intertransverse process arthrodesis. J Bone Joint Surg Am 1991; 73: 802-8.
8. Radcliff KE, Kepler CK, Jakoi A, et al. Adjacent segment disease in the lumbar spine following different treatment interventions. Spine J 2012; 13: 1339-49.
9. Reeves NP, Narendra KS, Cholewicki J. Spine stability: the six blind men and the elephant. Clin Biomech 2008; 22: 266-74.
10. Adams MA, Roughley PJ. What is intervertebral disc degeneration, and what causes it? Spine 2006; 31: 2151- 61.
11. Farfan HF, Cossette JW , Robertson GH, Wells RV , Kraus H. The effects of torsion on the lumbar intervertebral joints: the role of torsion in the production of disc degeneration. J Bone Joint Surg Am 1970; 52: 468-97.
12. Gordon SJ, Yang KH, Mayer PJ, Mace AH, Jr, Kish VL, Radin EL. Mechanism of disc rupture. A preliminary report. Spine 1991; 16: 450-6.
13. Adams MA, Hutton WC. The relevance of torsion to the mechanical derangement of the lumbar spine. Spine 1881; 6: 241-8.
14. Farfan HF. Effects of torsion on the intervertebral joints. Can J Surg 1969; 12: 336-41.
15. Pietrantonio A, Trungu S, Famà I, Forcato S, Miscusi M, Raco A. Long-term clinical outcomes after bilateral laminotomy or total laminectomy for lumbar spinal stenosis: a single-institution experience. Neurosurg Focus 2019; 46: E2.
Article available in :
Volume 5, Issue 6, 2022
Page : 1732-1735
https://doi.org/10.32322/jhsm.1180526
Article Information
Received : 26 Eyl 2022
Accepted : 19 Eki 2022
Published : 25 Eki 2022
Corresponding Author :

Güven Gürsoy: Muğla Sıtkı Koçman University, Faculty of Medicine, Neurosurgery Department, Muğla Turkey

gı[email protected]
Citation : Gürsoy G. Postlaminectomy instability–is fusion essential in degenerative lumbar stenosis surgery? J Health Sci Med 2022; 5(6): 1732-1735.

Read: 609
Cited: 2
Download : 245
_Footer