Introduction: We aimed to evaluate the efficacy of the transspinous approach compared with the conventional
laminectomy in degenerative lumber spinal stenosis with or without disc herniations.
Methods: Clinical data of the 198 patients, operated between the dates of April 2011 and June 2015 for degenerative lumber spinal stenosis, was analysed retrospectively. Patients were classified into two groups according to the type of surgery either conventional laminectomy (Group I; 101 patients) or the transspinous approach (Group II; 97 patients). Clinical outcome between the groups were assessed by comparing the length of inpatient hospital stay, postoperative pain, rate of postoperative neurologic deficit and complication, and extent of decompression.
Results: 33 patients in Group I and 23 patients in Group II underwent lumbar decompression with discectomy. Multi-level lumbar decompression was performed in 57 patients of Group I and in 47 patients of Group II. At postoperative pain evaluation, excellent, good, and fair outcomes were achieved in 77.4%, 16.9%, and 2,7% in Group I and 79%, 18.9%, and 2.2% in Group II, respectively. Satisfactory neurological decompression and symptom relief were achieved in 93% of these patients. Satisfactory decompression by means of increase in both mean spinal anteroposterior diameter and cross-sectional area were measured for transpinous approach when compared with the conventional laminectomy group. No statistically significant differences were identified in the rates of complications or length of inpatient hospital stay.
Conclusions: Compared with conventional laminectomy , transspinous decompression technique is an equally effective and minimal invasive technique in the treatment of degenerative lumbar stenosis with or without disc herniation.
Patient Care: The transspinous approach will provide minimal invasive surgery for the patient care.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of transpinous technique, 2) Compare the efficacy of the technique with the conventional approach 3) Identify an effective treatment for degenerative lumbar stenosis.