Naslov
Laminectomy with Augmented Fusion vs.Young Laminoplasty for the Treatment of Degenerative Spinal Stenosis

Autori
Stančić, Marin

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
26th Annual Meeting of the AANS/CNS section on Disorders of the spine and peripheral nerves / Shaffrey, Christopher I. - Orlando (FL) : AANS, 2010, 105-106

Skup
26th Annual meeting of the AANS/CNS section on disorders of the spine and peripheral nerves

Mjesto i datum
Orlando (FL), Sjedinjene Američke Države, 17.02.2010. - 20.02.2010

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
laminectomy; degenerative spinal stenosis; minimally invasive surgery

Sažetak
Variety of less invasive surgical techniques has almost totally replaced laminectomy with augmented fusion due to invasiveness, cost and x-ray exposure. Our aim was comparison between long-term outcomes of Young laminoplasty (YL) as one of the less invasive techniques and laminectomy with posterolateral fusion (LF) augmented with free hand pedicle screw fixation. Patients with neurogenic claudication and lumbar stenosis (LF and YL mean +/- SD dural sac area (mm2) = 53, 96 +/- 8, 39 ; 54, 26 +/- 10, 11 ; p=0, 914) were surgically treated from February 2000 to September 2002 in General Hospital Pula. Outcome was measured as difference in the Oswestry Disability Index (ODI) at 1-year and 7-year follow-up examinations. Duration of surgery, blood loss, incision length, hospital stay and cost were measured. 44 patients out of 56 patients were enrolled. Twenty-six patients were randomized in LF (No=13) and YL (No=13) groups while 18 were allocated in observational LF (No=13) and YL (No=5) cohorts. Significant improvement on 1-year and 7-year follow-up was noticed in LF and YL groups (26, 65, p<0, 001 ; 30, 25, p<0, 001 ; and 16, 05, p<0, 001 ; 28, 78, p<0, 001, respectively). LF ODI was significantly better compared to YL at 7-year follow-up (27, 82 +/- 1, 918 vs. 40, 74 +/- 2, 163 ; p<0, 001). No significant difference was found between the randomized and observational cohorts. There were two dura lacerations in YL group and no revision surgeries in FL group for correction of malpositioned screw. LF is a more invasive and expensive technique but with significantly better long-term outcome. Incremented cost- effectiveness ratio was $153 per one 7-year follow-up ODI grade.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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