Our Summary

This research paper compares two types of surgery for a condition called lumbar spinal canal stenosis, where the spaces in the spine are too small and put pressure on the nerves. The two surgeries are microendoscopic laminectomy (MEL) and open laminectomy.

In the MEL procedure, a small tube with a camera is used to do the surgery, while in open laminectomy, a larger incision is made to open up the spine for the procedure.

The study finds that the MEL procedure takes less time, causes less blood loss during the operation, and results in a shorter stay in the hospital after the operation compared to open laminectomy. However, the chances of complications happening were similar for both types of surgeries, and the improvements patients reported after either surgery were also similar.

One interesting finding was that more patients who had the MEL procedure said they were satisfied with the treatment compared to those who had the open laminectomy.

So, overall the MEL procedure seems to have some advantages over open laminectomy, but more research is needed to confirm these findings.

FAQs

  1. What is lumbar spinal canal stenosis and how is it treated?
  2. How do the microendoscopic laminectomy (MEL) and open laminectomy procedures compare in terms of operation time, blood loss, and hospital stay duration?
  3. What are the patient satisfaction levels for the MEL procedure compared to open laminectomy?

Doctor’s Tip

In addition to surgery, a doctor might also recommend non-surgical spinal decompression therapy as a treatment option for spinal conditions. This therapy involves gently stretching the spine to relieve pressure on the discs and nerves, promoting healing and reducing pain. Patients may benefit from combining both surgical and non-surgical approaches to achieve the best results for their specific condition. It’s important to discuss all treatment options with your doctor to determine the best course of action for your individual needs.

Suitable For

Patients who are recommended spinal decompression typically have conditions such as lumbar spinal canal stenosis, herniated discs, degenerative disc disease, sciatica, and other spinal conditions that cause compression of the nerves in the spine. These patients may experience symptoms such as back pain, leg pain, numbness, tingling, weakness, and difficulty walking or standing.

Spinal decompression therapy, including procedures like microendoscopic laminectomy or open laminectomy, may be recommended for patients who have not found relief from conservative treatments such as physical therapy, medication, injections, or chiropractic care. These procedures aim to relieve pressure on the nerves in the spine, reduce pain and other symptoms, and improve overall function and quality of life for the patient.

It is important for patients to consult with a spine specialist or orthopedic surgeon to determine if spinal decompression surgery is the right treatment option for their specific condition and individual needs. The decision to undergo spinal decompression surgery should be made after a thorough evaluation of the patient’s medical history, symptoms, imaging studies, and overall health status.

Timeline

Before spinal decompression surgery, a patient may experience symptoms such as back pain, leg pain, numbness, tingling, weakness, and difficulty walking. They may undergo diagnostic tests such as MRI or CT scans to determine the cause of their symptoms.

During the spinal decompression surgery, the patient is placed under anesthesia, and the surgeon will make a small incision in the back to access the affected area of the spine. The surgeon will then remove a portion of the bone or disc that is putting pressure on the nerves, creating more space in the spinal canal.

After the surgery, the patient may experience some pain and discomfort at the incision site, which can be managed with pain medication. Physical therapy may also be recommended to help strengthen the muscles supporting the spine and improve range of motion.

Over time, most patients experience a reduction in their symptoms such as pain, numbness, and weakness, as the pressure on the nerves is relieved. It may take several weeks to months for the full benefits of spinal decompression surgery to be realized, but many patients report significant improvement in their quality of life and ability to perform daily activities.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal decompression, specifically regarding the comparison between microendoscopic laminectomy (MEL) and open laminectomy, may include:

  1. What are the specific differences between MEL and open laminectomy in terms of procedure, recovery time, and potential risks?
  2. Based on my individual case, which procedure do you recommend and why?
  3. What are the potential benefits of choosing MEL over open laminectomy for my condition?
  4. Are there any specific factors that would make me a better candidate for one procedure over the other?
  5. How experienced are you in performing the MEL procedure compared to open laminectomy?
  6. What is the success rate of each procedure for patients with lumbar spinal canal stenosis?
  7. Are there any long-term differences in outcomes or complications between MEL and open laminectomy?
  8. How soon can I expect to see improvements in my symptoms after undergoing either procedure?
  9. What post-operative care or rehabilitation will be necessary for each procedure?
  10. Are there any additional resources or information I should review before making a decision between MEL and open laminectomy?

Reference

Authors: Ohtomo N, Nakamoto H, Miyahara J, Yoshida Y, Nakarai H, Tozawa K, Fukushima M, Kato S, Doi T, Taniguchi Y, Matsubayashi Y, Higashikawa A, Takeshita Y, Kawamura N, Inanami H, Tanaka S, Oshima Y. Journal: BMC Musculoskelet Disord. 2021 Dec 20;22(1):1053. doi: 10.1186/s12891-021-04963-6. PMID: 34930238