Our Summary

This research paper compares two types of surgery for a condition called lumbar spinal stenosis, which is a narrowing of the spaces in your spine that can put pressure on the nerves.

The two surgeries are:

  1. Total laminectomy and fusion, which involves removing part of the bone (the lamina) that’s causing pressure on the nerves, and then fusing the spine together.

  2. Bilateral decompression via a unilateral approach, which involves making one small cut and then removing part of the bone from both sides of the spine.

The results showed that both surgeries were equally effective in reducing pain for patients. However, the total laminectomy and fusion surgery was 2.5 times more expensive than the bilateral decompression surgery.

This suggests that the less invasive bilateral decompression surgery is a more cost-effective option for treating lumbar spinal stenosis.

FAQs

  1. What is lumbar spinal stenosis and how is it treated?
  2. What is the difference between total laminectomy and fusion surgery and bilateral decompression surgery?
  3. Which surgery for lumbar spinal stenosis is more cost-effective according to the research?

Doctor’s Tip

Therefore, a helpful tip a doctor might tell a patient about spinal decompression is that they should consider discussing the option of bilateral decompression via a unilateral approach with their healthcare provider as a more cost-effective and minimally invasive treatment option for their condition. It is important to weigh the benefits and risks of each surgery and make an informed decision based on individual needs and preferences.

Suitable For

Patients who are recommended spinal decompression surgery are typically those who are experiencing symptoms of lumbar spinal stenosis, such as lower back pain, leg pain, numbness or weakness in the legs, and difficulty walking or standing for long periods of time. These symptoms are often caused by the narrowing of the spaces in the spine that put pressure on the nerves, leading to pain and discomfort.

Patients who have tried conservative treatments such as physical therapy, medication, and injections with no improvement in their symptoms may be recommended for spinal decompression surgery. Additionally, patients who have severe symptoms that significantly impact their quality of life and daily activities may also be candidates for spinal decompression surgery.

It is important for patients to consult with their healthcare provider to determine if spinal decompression surgery is the right treatment option for their specific condition and to discuss the potential risks and benefits of the procedure.

Timeline

Timeline of patient experience before and after spinal decompression:

Before surgery:

  • Patient experiences chronic back pain, leg pain, and numbness or weakness in the legs.
  • Patient undergoes imaging tests such as X-rays, CT scans, or MRI to diagnose the condition.
  • Patient consults with a spine surgeon to discuss treatment options.
  • Decision is made to undergo spinal decompression surgery.

During surgery:

  • Patient is put under general anesthesia.
  • Surgeon makes a small incision and removes part of the bone or disc that is causing pressure on the nerves.
  • Procedure typically takes 1-2 hours.

After surgery:

  • Patient may experience some pain or discomfort at the incision site.
  • Patient is usually able to go home the same day or after a short hospital stay.
  • Recovery time varies, but most patients are able to return to normal activities within a few weeks.
  • Physical therapy may be recommended to help strengthen the back and improve flexibility.
  • Follow-up appointments with the surgeon are scheduled to monitor progress and address any concerns.

Overall, spinal decompression surgery can provide significant relief for patients with lumbar spinal stenosis, allowing them to regain mobility and improve their 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 risks and complications associated with spinal decompression surgery?
  2. How long is the recovery time for spinal decompression surgery?
  3. What are the success rates for spinal decompression surgery in treating my specific condition?
  4. Are there any alternative treatments or therapies that I should consider before opting for spinal decompression surgery?
  5. Will I need physical therapy or rehabilitation after the surgery?
  6. How long will the effects of spinal decompression surgery last?
  7. What is the difference in cost between total laminectomy and fusion surgery and bilateral decompression surgery?
  8. Are there any specific criteria that make me a better candidate for one type of surgery over the other?
  9. How many times have you performed spinal decompression surgery, and what is your success rate with this procedure?
  10. Can you provide me with any patient testimonials or references from previous spinal decompression surgery patients?

Reference

Authors: Kayalar AE, Onen MR, Gerilmez A, Naderi S. Journal: Turk Neurosurg. 2019;29(5):643-650. doi: 10.5137/1019-5149.JTN.24318-18.1. PMID: 31353433