Minimally Invasive Bilateral Decompressive Lumbar Laminectomy with Unilateral Approach Among Obese versus Nonobese...

Area of Science:

• Neurosurgery
• Spinal Surgery
• Minimally Invasive Surgery

Background:

• Decompressive lumbar laminectomy (DLL) is a standard treatment for lumbar stenosis.
• A unilateral approach to DLL aims to reduce iatrogenic instability compared to traditional open methods.
• The safety and efficacy of minimally invasive DLL in obese patients remain under investigation.

Purpose of the Study:

• To compare operative details, perioperative outcomes, and complication rates between obese and nonobese patients undergoing DLL via a unilateral approach.
• To evaluate the impact of obesity on the outcomes of this specific microsurgical technique.

Main Methods:

• A retrospective review of 194 patients who underwent DLL with a unilateral approach.
• Patients were categorized into obese (BMI ≥30.0 kg/m²) and nonobese (BMI <30.0 kg/m²) groups.
• Comparison of operative time, blood loss, durotomy rates, wound drainage, and length of stay.

Main Results:

• Obese patients had a nonsignificantly increased operative time (177 vs. 166 minutes) and nonsignificantly lower blood loss (91 mL vs. 97 mL).
• Durotomy and wound drainage rates were similar between obese and nonobese groups.
• Obese patients experienced a significantly longer length of hospital stay (1.5 vs. 1.0 days).

Conclusions:

• The unilateral DLL approach demonstrated similar perioperative complication rates in obese and nonobese patients.
• While obese patients had a significantly longer hospitalization, the technique is considered safe across weight categories.
• Further research may explore strategies to optimize recovery for obese patients undergoing this procedure.