Document Type : Original Articles
Authors
1
Neurosurgery department, Menoufia university, Faculty of medicine, Menoufia, Egypt.
2
Head of neurosurgery department, Menoufia university, Faculty of medicine, Menoufia, Egypt.
3
Neurosurgery resident at neurosurgery department of faculty of medicine of Menoufia university
4
General Practitioner at ministry of health, Menoufia, Egypt
5
Assistant lecturer at neurosurgery department, Menoufia university, Faculty of medicine, Menoufia, Egypt.
Abstract
Background: A study focused on lumbar spinal stenosis (LSS), a common condition affecting nearly 47% of elderly individuals. LSS results from various degenerative changes causing neural tissue compression. To address this, researchers investigated a multilevel laminectomy procedure utilizing an oscillating bone saw, aiming to assess its impact on surgery duration and complication frequency, particularly dural injuries. The study emphasizes the need to optimize surgical tools to mitigate associated morbidity.
Methods: All patients had their full medical histories evaluated and underwent general physical and neurological examinations. Both magnetic resonance imaging (MRI) and lumbosacral x-rays were performed on all cases. We analyzed the extent of stenosis and instability across all levels using physical and radiographic methods. We conducted posterolateral fusion with instrumentation 1 in those who, according to the preoperative flexion/extension X-rays, have spinal instability or deformity. Moreover, we fused the tissue using an autograft made from the removed laminae.
Results: Results showed that laminectomies were performed at varying levels: one level in 39% of patients, two levels in 36.8%, three levels in 18.4%, and four levels in 5.2%. The mean time for laminectomy at each level was 3.3 minutes, ranging from 1.5 to 6 minutes per level, with blood loss averaging 6.4 ml per level. Notably, no dural tears occurred during laminectomy, and only 7.9% of cases experienced incidental durotomy during decompression with Kerrison, not during laminectomy itself.
Conclusion: According to our study, laminectomy using an oscillating bone saw was a safe, efficient method of treating lumbar canal stenosis.
Keywords
)
View on SCiNiTO