Hemilaminectomy and Bilateral Decompression for Thoracic Spinal Stenosis

Area of Science:

• Neurosurgery
• Spinal Surgery
• Orthopedics

Background:

• Thoracic spinal stenosis (TSS) can result from posterior element hypertrophy.
• Surgical intervention is often necessary for managing narrow spinal canals.

Purpose of the Study:

• To evaluate the effectiveness and reliability of hemilaminectomy and bilateral decompression (HLBD) for treating thoracic spinal stenosis.
• To assess clinical outcomes and complication rates associated with HLBD.

Main Methods:

• Retrospective analysis of 21 adult patients who underwent HLBD for TSS.
• Diagnosis confirmed by CT or MRI, with stenosis due to posterior element hypertrophy.
• Pre- and postoperative modified Japanese Orthopedic Association (JOA) scores and Hirabayashi's recovery rate were used for evaluation.

Main Results:

• Mean JOA score improved significantly from 5.0 preoperatively to 10.0 postoperatively.
• Achieved a recovery rate of 83.3% among the studied patients.
• No operation-related transfusions, neurological deterioration, or postoperative instability were reported.

Conclusions:

• HLBD is a suitable surgical option for TSS caused by posterior element hypertrophy (e.g., ligamentum flavum, facet joints).
• The procedure protects posterior anatomical structures, preventing kyphosis and instability.
• HLBD demonstrates successful clinical improvement with a relatively low complication ratio.