engleski

Young’ s laminoplasty may not be a less invasive alternative to facet sparing laminectomy in the treatment of lumbar spinal canal stenosis: Randomized controlled trial

Aim. Facet-sparing laminectomy (FSL) is an efficient method for the treatment of lumbar spinal stenosis. Young introduced laminoplasty consisting of interlaminectomy with contralateral decompression under the midline posterior structures. Interest for Young&#900; s laminoplasty (YL) further increased with introduction of endoscopic surgical techniques. Objective of the study was clinical validation of YL by comparing it with FSL in the randomized controlled trial. Methods. Forty-four patients with a lumbar spinal stenosis were individually randomized into the trial (YL, N=22) and control group (FSL, N=22). Differences between the preoperative and 3 year follow-up Oswestry disability index (ODI), and the activity assessed according to the Prolo scale were evaluated as the primary outcome. Duration of surgery, blood loss, and incision length and hospitalisation duration were measured as the secondary outcome. Statistical analysis was made using the Student test, Wilcoxon's nonparametric test and Mann-Whitney U-test. Results. 20 male and 24 female patients, (mean age 64.15&plusmn ; ; 14.24 )were operated on from February 15, 2000 to September 1, 2002, and followed up for 3 years. In the FSL group both the ODI and activity outcomes were better than in the YL group (mean ODI 28, 18&plusmn ; ; 2, 61 vs. 41, 0&plusmn ; ; 4, 69, p<0.0098, E score 4.25&plusmn ; ; 0.72 vs. 3.65&plusmn ; ; 0.59, p=.017). There were no differences between the trial and control group with regard to duration of surgery, blood loss, incision length, and and hospitalisation duration. Conclusion. Our results suggest that Young laminoplasty is not as efficient as facet sparing laminectomy. It has also been shown that it is not less invasive than facet sparing laminectomy.

Facet-sparing laminectomy (FSL); Young&#900; s laminoplasty (YL); surgical procedure; decompression

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