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Outcome after laminectomy for lumbar spinal stenosis. Part II: Radiographic changes and clinical correlations
G F Tuite1, S E Doran, J D Stern
1Section of Neurosurgery, University of Michigan Hospital, Ann Arbor.
Journal of Neurosurgery
|November 1, 1994
Summary
Decompressive lumbar laminectomy can cause significant radiographic changes at operated spinal levels. Some postoperative symptoms correlate with these changes, suggesting lumbar fusion may benefit select patients.
Area of Science:
- Orthopedic Surgery
- Neurosurgery
- Radiology
Background:
- Decompressive lumbar laminectomy is a common procedure for spinal stenosis.
- Radiographic changes following laminectomy are not fully understood.
- The relationship between radiographic findings and clinical outcomes needs further investigation.
Purpose of the Study:
- To evaluate radiographic changes after decompressive lumbar laminectomy.
- To correlate these radiographic changes with clinical outcomes.
- To assess the potential role of lumbar fusion in managing postoperative symptoms.
Main Methods:
- Retrospective analysis of lumbar spine radiographs from 119 patients.
- Radiographs taken preoperatively and postoperatively (average 4.6-year interval).
- Utilized an accurate and reproducible measurement method for radiographic parameters.
Main Results:
- Operated spinal levels exhibited greater changes in spondylolisthesis, disc space angle, and disc space height compared to unoperated levels.
- Radiographic changes at both operated and unoperated levels correlated with patient outcomes.
- Postoperative symptoms were found to correlate with specific radiographic alterations.
Conclusions:
- Decompressive lumbar laminectomy leads to more pronounced radiographic changes at operated spinal levels.
- Clinical outcomes are associated with these postoperative radiographic changes.
- Lumbar fusion should be considered for specific patients undergoing decompressive laminectomy, pending further randomized controlled trials.