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. 2024 Dec 20;16(12):e76097.
doi: 10.7759/cureus.76097. eCollection 2024 Dec.

Progression of Lumbar Spine Degeneration After Laminectomy

Kunihiko Hashimoto  1 , Kazuma Kitaguchi  1   2 , Daisuke Tateiwa  1 , Kazuya Oshima  1 , Eiji Wada  1
Affiliations

Progression of Lumbar Spine Degeneration After Laminectomy

Kunihiko Hashimoto et al. Cureus. .

Abstract

Introduction: Lumbar canal stenosis (LCS) is a common degenerative lumbar spinal disease (DLSD) widely treated by decompression surgery, also known as laminectomy. Few cases have been observed where DLSD has progressed postoperatively, thus requiring reoperation. However, data on such cases are limited.

Methods: We included 247 patients (148 men and 99 women; mean age = 73.3 years) with a mean follow-up of 2.3 years in this single-center retrospective study. Among them, 129 patients underwent bilateral partial laminectomy (BPL), 91 patients underwent lumbar spinous process-splitting laminectomy (LSPSL), and 27 underwent microendoscopic laminotomy (MEL).

Results: Of all the patients, 34 (13.8%) exhibited progression of lumbar spine degeneration symptoms, with nine (3.6%) requiring reoperation. Over 90% of new symptoms developed within one year of the initial surgery. Reoperation rates were significantly higher in patients with foraminal stenosis (P = <0.001). Additionally, 35 patients (14.2%) exhibited slippage progression. LSPSL resulted in significantly less slippage progression (P = 0.026). Spinal canal and foraminal stenosis were significantly associated with slippage progression (P< 0.001 and P = 0.010, respectively).

Conclusions: LSPSL reduced the incidence of canal and foraminal stenosis. Symptomatic DLSD was more common within one year post surgery, with foraminal stenosis more frequently requiring reoperation.

Keywords: degenerative lumbar spinal disease (dlsd); laminectomy; lumbar canal stenosis (lcs); reoperation; surgical procedures.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. The Ethics Committee of Osaka International Medical & Science Center issued approval 2051. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Flowchart showing patient exclusion criteria.
MEL: microendoscopic laminotomy.
Figure 2
Figure 2. Three-dimensional computed tomography images after surgery.
Three-dimensional computed tomography images after bilateral partial laminectomy (A), lumbar spinous process-splitting laminectomy (B), and microendoscopic laminotomy (C).
Figure 3
Figure 3. Timing of symptom onset and reoperation rates associated with the progression of degenerative lumbar spinal disease.
See this image and copyright information in PMC

References

    1. Preoperative and postoperative instability in lumbar spinal stenosis. Johnsson KE, Redlund-Johnell I, Udén A, Willner S. Spine (Phila Pa 1976) 1989;14:591–593. - PubMed
    1. Local denervation atrophy of paraspinal muscles in postoperative failed back syndrome. Sihvonen T, Herno A, Paljärvi L, Airaksinen O, Partanen J, Tapaninaho A. Spine (Phila Pa 1976) 1993;18:575–581. - PubMed
    1. Clinical outcomes and radiological instability following decompressive lumbar laminectomy for degenerative spinal stenosis: a comparison of patients undergoing concomitant arthrodesis versus decompression alone. Fox MW, Onofrio BM, Onofrio BM, Hanssen AD. J Neurosurg. 1996;85:793–802. - PubMed
    1. Relation between laminectomy and development of adjacent segment instability after lumbar fusion with pedicle fixation. Lai PL, Chen LH, Niu CC, Fu TS, Chen WJ. Spine (Phila Pa 1976) 2004;29:2527–2532. - PubMed
    1. Bilateral partial laminectomy: a treatment for lumbar spinal stenosis and midline disc herniation. Eule JM, Breeze R, Kindt GW. Surg Neurol. 1999;52:329–338. - PubMed

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