Our Summary

This research study compares two different types of back surgery for a condition called lumbar spinal stenosis (LSS), where the spinal canal in the lower back becomes narrowed. The study looked at traditional decompression surgery (CD) and a newer technique called spinous process-splitting laminectomy (SPSL), which claims to cause less damage to the muscles surrounding the spine.

The researchers looked back at the medical records of 106 patients who had either CD or SPSL surgery between 2015 and 2020. They compared the patients’ symptoms before surgery, their recovery, how much pain medication they needed after surgery, and how much pain they reported in the hospital.

The researchers found that about a third of patients in both groups were already taking strong painkillers before their surgery. Patients who had the newer SPSL surgery reported more pain on the first day after surgery but significantly less pain on the third and fifth day. They also needed less pain medication, especially paracetamol, by the fifth day. The overall outcome was similar for both groups, with patients reporting improved movement after surgery. There was no significant difference in the number of complications or cases where the spinal canal narrowed again.

In simple terms, the study suggests that patients who had the newer SPSL surgery experienced less pain a few days after surgery and needed less pain medication, even though they had more pain immediately after surgery. The overall outcome was similar for both types of surgery.

FAQs

  1. What is the difference between traditional decompression surgery (CD) and the newer technique called spinous process-splitting laminectomy (SPSL)?
  2. Did the study find a significant difference in recovery time and pain levels between patients who underwent CD and those who underwent SPSL?
  3. What are the similarities and differences in the overall outcomes of CD and SPSL surgeries according to the study?

Doctor’s Tip

A helpful tip a doctor might give a patient about spinal decompression is to consider the potential benefits of newer techniques such as spinous process-splitting laminectomy (SPSL). While it may cause more immediate pain compared to traditional decompression surgery (CD), patients who undergo SPSL surgery may experience less pain in the days following surgery and require less pain medication. It’s important to discuss all available options with your healthcare provider to determine the best approach for your specific condition.

Suitable For

Patients who are typically recommended spinal decompression surgery, such as traditional decompression surgery or spinous process-splitting laminectomy, are those suffering from conditions like lumbar spinal stenosis (LSS) where the spinal canal in the lower back becomes narrowed. These patients may experience symptoms such as back pain, leg pain, numbness, tingling, weakness, and difficulty walking. Patients who have not responded to conservative treatments like physical therapy, medication, and injections may be candidates for spinal decompression surgery. Additionally, patients with severe symptoms that significantly impact their quality of life and daily activities may also be recommended for spinal decompression surgery.

Timeline

Before spinal decompression surgery, a patient may experience symptoms such as back pain, leg pain, numbness, tingling, weakness, and difficulty walking due to spinal stenosis. They may have tried conservative treatments such as physical therapy and pain medication without success.

After spinal decompression surgery, a patient may experience immediate post-operative pain and discomfort, which can be managed with pain medication. Over the following days and weeks, they may notice improvements in their symptoms, such as reduced pain, improved mobility, and decreased reliance on pain medication. Physical therapy may be recommended to help strengthen the muscles surrounding the spine and aid in recovery. Ultimately, the goal of spinal decompression surgery is to alleviate symptoms and improve the patient’s quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal decompression include:

  1. What are the potential benefits of both traditional decompression surgery (CD) and spinous process-splitting laminectomy (SPSL) for my condition?
  2. What are the risks and potential complications associated with each type of surgery?
  3. How long is the recovery process for each type of surgery, and what can I expect in terms of pain management during the recovery period?
  4. Are there any specific factors about my medical history or condition that would make one type of surgery more suitable for me than the other?
  5. How experienced are you in performing both types of surgery, and what is your success rate with each?
  6. Are there any alternative treatments or non-surgical options that I should consider before deciding on spinal decompression surgery?
  7. How will my mobility and quality of life be affected after the surgery, and what kind of physical therapy or rehabilitation will be necessary?
  8. What is the long-term outlook for my condition after undergoing either CD or SPSL surgery?
  9. Are there any specific lifestyle changes or precautions I should take after surgery to prevent a recurrence of spinal stenosis?
  10. Can you provide me with any additional resources or information to help me make an informed decision about my treatment options for spinal decompression surgery?

Reference

Authors: Voglis S, Tosic L, Höbner LM, Hofer AS, Stienen MN, Regli L, Bellut D, Dias SF. Journal: World Neurosurg. 2022 Apr;160:e80-e87. doi: 10.1016/j.wneu.2021.12.094. Epub 2021 Dec 29. PMID: 34973440