MICROSCOPIC LAMINOTOMIES FOR DEGENERATIVE LUMBAR SPINAL STENOSIS

In this retrospective study, we investigated 50 patients who had under gone primary lumbar microsurgical multiple laminotomy without spinal f usion for degenerative spinal stenosis. There were 31 men and 19 women with a median age of 66 years (35-85 years). Thirteen patients had gr ade I spondylolisthesis, most at L4-L5 levels (11 of 13). Single-level laminotomy was done in 13 patients, two levels in 30, and three level s in 7. The median follow-up period was 27 months (range, 15-48 months ). A standardized self-reported questionnaire was used for clinical ou tcome study. The demographic data and clinical features of these patie nts were analyzed for the prognostic factors. The analysis showed exce llent results in 18 patients, good in 16, fair in 8, and poor in 8, wh ereas 30 patients reported that they were very satisfied with the surg ery results, 10 were somewhat satisfied, 2 were somewhat dissatisfied, and 8 were very dissatisfied. Therefore, the satisfactory rate of the surgery was higher if judged by patient satisfaction. Among the param eters analyzed, the presence of neurogenic claudication (p = 0.008), c oexisting disease (p = 0.04), and the absence of motor deficit (p = 0. 03) were associated with lower total scores. In addition, longer durat ion of symptoms (p = 0.04) was associated with less improvement of bac k pain score, whereas the absence of motor deficit (p = 0.004) was ass ociated with less improvement of leg pain score. The presence of spond ylolisthesis did not affect outcomes.