Spinous Process-Splitting Laminectomy Versus Conventional Laminectomy: A Short-Term Outcome Study

Area of Science:

• Orthopedics
• Neurosurgery
• Spine Surgery

Background:

• Symptomatic lumbar spine stenosis (LSS) is a prevalent degenerative spinal condition causing back and neurogenic claudication pain.
• Conventional laminectomy (CL) for LSS can lead to iatrogenic paraspinal muscle injury and associated morbidity.
• Spinous process-splitting laminectomy (SPSL) is a muscle-preserving technique aiming to improve functional outcomes and reduce postoperative pain.

Purpose of the Study:

• To compare the clinical and surgical outcomes of spinous process-splitting laminectomy (SPSL) versus conventional laminectomy (CL) in patients with lumbar spine stenosis.

Main Methods:

• A retrospective comparative study involving 27 patients with symptomatic LSS.
• Evaluation of operative time, blood loss, postoperative pain (Visual Analog Scale - VAS), Oswestry Disability Index (ODI), and time to return to daily activities.
• Comparison between the SPSL group (14 patients) and the CL group (13 patients).

Main Results:

• SPSL group showed significantly less intraoperative blood loss (123.21 ml vs. 188.46 ml) and shorter operative time (67.86 min vs. 87.69 min) compared to CL.
• Lower postoperative VAS scores for low back pain at day one (2.0 vs. 2.8) and six months (0.21 vs. 0.77) in the SPSL group.
• SPSL group achieved significantly better ODI scores (2.21 vs. 4.38) and a much earlier return to daily activities (2.07 days vs. 6.77 days) than the CL group.

Conclusions:

• Spinous process-splitting laminectomy (SPSL) is a minimally invasive surgical option for lumbar spine stenosis.
• SPSL offers significant advantages over conventional laminectomy (CL), including reduced operative time, blood loss, and postoperative pain.
• Patients undergoing SPSL experience improved functional recovery and an earlier return to daily activities.