The Short-term Outcome Of Subtotal Laminectomy Decompression With Using Thin Blade Osteotome For Lumbar Spinal Stenosis

Objective: To compare the short-term clinical efficacy of the treatment of subtotal laminectomy decompression with using thin blade osteotome and traditional rongeur surgery for lumbar spinal stenosis.Methods: Retrospectively analyzed the data from September 2014 to September 2016,there are 86 lumbar spinal stenosis patients(47 male and 39 female),with an average age of 61.8 years,under surgical treatment.The stenosis segment of the control group,which has 40 cases,receive traditional rongeur surgery.The stenosis segment of the experimental group,which has 46 cases,were treated with subtotal laminectomy decompression by the use of thin blade osteotome.To compare the operation time,intraoperative blood loss and drainage changes of the two groups of patients,internal fixation fusion is employed to the sondylolisthesis and unstability segment and the short segment.All patients were followed up for 9 to 18 months.The surgical results are evaluated according to the data before the operation,6 months after the operative,the last follow-up in the VAS and ODI scoring system and modified Macnab of the two groups,and the lumbar vertebrae stability was re-examined by X-ray.Results: The operation of the two groups is successful,without intraoperative nerve root injury,cerebrospinal fluid leakage complications.Compared with the control group,the operation time of the experimental group was significantly shorter in the experimental group [(2.02±0.25)h vs(2.99±0.18)h],and the intraoperative blood loss was decreased [(219.35±26.45)m L vs(264.75±28.19)m L](P<0.05),but there is no significant change in the drainage volume([242.28±23.06)m L vs(250.50±19.67)m L],thus there is no statistical significance(P> 0.05).Compared within each group, the VAS score and ODI score were significantly lower than the score before operation(P<0.05).Compared between the two groups,the VAS score and ODI score of at the time of 6 months after operation and the last follow-up in the experimental group were lower than those in the control group(P<0.05).In the control group,there were 29 cases(72.5%)with excellent postoperative symptoms,the good rate was 82.5%,while that of the experimental group was 38 cases(80.43%)and 87% respectively.There is no unstability or slippage in the last follow-up,and the lumbar vertebrae function of the patients in the two groups sees a certain recovery after operation,but the difference between the two groups is not statistically significant(P>0.05).Conclusions: For the treatment of lumbar spinal stenosis,the short-term efficacy of subtotal laminectomy decompression with using thin blade osteotome is favorable,which can effectively expand spinal canal and complete decompression,reduces the operation time and intraoperative bleeding,and significantly relieve the patient’s symptoms,maintain the stability of the spine,but the lack of long-term follow-up.