요추관협착증 환자에 대한 단순 황색인대 제거술의 수술적 결과

Abstract

Objective : The purpose of this study is to describe the surgical techniques of simple ligamentectomy without fusion for the treatment of lumbar stenosis and to review the postoperative outcomes in resolution of pain and improvement of functional status. Methods : The authors reviewed clinical and radiologic findings of 458 patients with lumbar spinal stenosis who had underwent simple ligamentectomy between January 1998 and December 2003. Preoperative and postoperative clinical symptoms and neurologic functional status were reviewed along with complication to evaluate the efficacy of the surgery. Results : Mean follow-up period was 4 years. Operation time and average length of hospitalization in simple ligamentectomy cases were significantly shorter than in wide laminectomy with fusion cases and less amount of blood loss and lower rate of infection were observed in simple ligamentectomy cases. Back pain and leg pain measured by VAS score were improved postoperative from preopertative 5.9 ± 2.8 to postoperative 3.1 ± 3.0 and 7.4 ± 2.4 to 2.9 ± 2.6, respectively. Walking difficulty (preoperative 7.7 ± 2.2) was improved to 3.3 ± 3.2 postoperatively. There were no facet fracture, recurrence of radicular pain, instability and neurogenic intermittent claudication during the follow-up period. Conclusion : The sublaminar ligamentectomy in lumbar spinal stenosis did not cause weakness of lamina and fracture of inferior articular processes and it provided satisfactory postoperative results without recurrence. This procedure has been found to be an effective and safe procedure with rare complications.