퇴행성 요추 척추관 협착증의 감압술 방법에 따른 결과 비교

Abstract

Objectives: To analyse the radiographic and clinical results of the three posterior element saving decompression techniques for lumbar degenerative spinal stenosis. Summary of Literature Review: Minimal invasive decompression reduces morbidity and hospital stay. Materials and Methods : 30 patients who were treated with posterior element saving microscopic decompression for lumbar spinal stenosis without instability during the period between March, 2002 and February, 2004 were evaluated. The procedures were bilateral laminotomy (10 cases), spinous process osteotomy (8 cases) and laminoplasty (12 cases). We evaluated estimated blood loss, amount of transfusion, complications and radiographic instability at last follow-up. Clinical results were evaluated with Oswestry disability index(ODI) and visual analogue scale(VAS) for buttock and leg pain preoperative and postoperative 1, 3, 6, 12 month, respectively. Results : There were no radiographic instability at last follow up. Mean ODI and VAS were substantially improved at postoperative 1 month and then marginally improved afterwards. But there were no significant difference among three procedures statistically(p＞0.05). Mean blood loss and amount of transfusion of each level were 290 ml and 0.5 U in bilateral laminotomy, 370 ml and 0.9 U in spinous process osteotomy and 180 ml and 0.1 U in laminoplasty, respectively. Conclusion : There were no significant differences in radiograhic and clinical results among bilateral laminotomy, spinous process osteotomy and laminoplasty. But, in terms of blood loss and transfusion, laminoplasty was better than another techniques. We authors believe that laminoplasty is useful and safe technique for degenerative lumbar spinal stenosis.