A Comparison of Bilateral Decompression via Unilateral Approach and Classic Laminectomy in Patients with Lumbar Spinal Stenosis in terms of postoperative back pain.

Abstract

Back ground: Lumbar spinal stenosis (LSS) is a common cause of morbidity in elderly patients due to degenerative changes ofspine. Different surgical procedures have been proposed including open lumbar laminectomy and other less invasivedecompressive procedures to minimize soft tissue damage and lessen the post-operative complication. So we conducted thisstudy to find more appropriate and less invasive procedure.Objective: To compare mean post-operative back pain score in patients with lumbar spinal stenosis undergoing bilateraldecompression via unilateral approach versus classic laminectomy.Material and Methods: This randomized control trial was carried out in department of neurosurgery, Saidu Teaching HospitalSharif Swat from April 2018 to October 2018.Atotal of 60 patients having confirmed degenerative lumbar spine stenosis with painscore of >5 on Visual Analogue Score (VAS) presenting in outpatient department were included in the study. Patients not willing forthe study and fulfilling the set exclusion criteria were excluded. Patients were divided in two groups randomly on basis of lotterymethod. Written informed consent was taken and VAS at presentation of all patients was recorded. In group Apatient underwentbilateral decompression via unilateral approach. In-group B patient underwent classic laminectomy. Pain evaluation in both groupsvia Visual Analogue Scoring was recorded before surgery and at 1month post-operative follow-up. Follow up was advised at a 2weeks interval and final outcome was measured at 1 month post operatively. Data collected was analyzed through SPSS 22.Results: In our study the mean age of the patients was 59.12±12.88 years, the male to female ratio was 0.9:1. Statistically highlysignificant difference was found between the study groups with pain at 1st month i.e. p-value=0.000.Conclusion: The bilateral decompression via unilateral approach had significantly reduced post-operative pain as compared toclassic laminectomy in patients with LSS.Key words: pain, classic laminectomy, bilateral decompression, unilateral approach, lumbar spinal Stenosis