In gratitude of the loyal support of our members, the CNS is offering complimentary 2021 Annual Meeting registration to all members! Learn more.

  • Long Term Outcomes and Quality of Life after Minimally Invasive Lumbar Laminectomy and in-Situ Posterior Fusion for Lumbar Spinal Stenosis

    Final Number:
    1488

    Authors:
    Mick J. Perez-Cruet MD MS; Esam A Elkhatib MD, PhD; Elizabeth Abel BS

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2018 Annual Meeting

    Introduction: Lumbar spinal stenosis is a common disorder that can result in significant disability, debilitating back pain and bad quality of life. Minimally invasive laminectomy and in situ posterior fusion surgery (MILISF) as a modality to treat different causes of debilitating symptomatic back pain can lead to excellent clinical outcomes.

    Methods: we reviewed 403 charts retrospectively with symptomatic lumbar stenosis operated using minimally invasive surgery. Data was collected on patient demographics, pre-operative imaging, complications, and reoperation rates. Outcome scales (Oswetry Disability Index (ODI) and Visual Analogue Scale (VAS)) were answered prospectively and over a 6-years follow-up period.

    Results: In 403 patients, 242 (60.8%) were females and 161 (39.2%) were males. The mean age was 63.9±12.4 years and mean BMI was 29.8±6.1 kg/m2 (. The average follow-up time was 2.3±1.6 years. Minimally invasive laminectomy was most commonly performed at the L3-4 level in 23.1% and at L4-5 level in 58.1% and at L5-S1 levels in 32.5%. Complications occurred in 34 (8.4%) cases and included wound problem (n=4, 0.9%), malpositioned screws (n=2, 0.5%), neurological post-operative deficit (n=2, 0.5%), bone graft and cage problem (n=1, 0.3%) and pulmonary embolism (n=3, 0.7%). Additional transient complications included post-operative pain (n=12, 2.9%), post-operative weakness (n=1, 0.3%),. Complications were evaluated by third party neurosurgeons. Mean OR time was 202.86±26.6 minutes, mean EBL was 97.5±51.8 cc3, and mean LOS was 3.6±3 days. Mean VAS scores improved from 6.98±2.2 pre-operative to 2.32±1.9, 2.86±1.6 at 1 year and 5 years follow up consequently (p>0.001). Mean ODI improved from 45.89±16.3 pre-operative to 21.98±17.7, and 22.01±17.6 at 1 and 5 years follow up consequently (p>0.001). Fusion rate was >97% measured at 3months and one year follow-up.

    Conclusions: MIL-ISF for lumbar stenosis is a safe and effective technique with excellent clinical outcomes and low complications rates.

    Patient Care: Minimally invasive laminectomy and in situ posterior fusion surgery (MILISF) as a modality to treat different causes of debilitating symptomatic back pain can lead to excellent clinical outcomes.

    Learning Objectives: MIL-ISF for lumbar stenosis is a safe and effective technique with excellent clinical outcomes and low complications rates.

    References:

We use cookies to improve the performance of our site, to analyze the traffic to our site, and to personalize your experience of the site. You can control cookies through your browser settings. Please find more information on the cookies used on our site. Privacy Policy