Our Summary

This study looked at a surgical technique called unilateral laminectomy for bilateral decompression (ULBD) which is used to treat lumbar spinal stenosis (LSS), a condition where the spinal canal narrows, causing pain and other symptoms. The technique is less invasive than traditional methods and has shown promising results in reducing lower back pain (LBP).

The researchers tracked 50 patients with LSS who underwent ULBD and measured their pain levels in different positions before and after surgery. They found that the surgery significantly reduced back pain, especially when standing, and this reduction in pain was consistent across different positions. Also, the surgery improved the pain on both sides of the back equally.

The results suggest that ULBD is effective in reducing lower back pain caused by LSS and that any asymmetrical invasion of the muscles and joints around the spine doesn’t affect residual pain after surgery.

FAQs

  1. What is unilateral laminectomy for bilateral decompression (ULBD) and what condition does it treat?
  2. How effective is the ULBD technique in reducing lower back pain in patients with lumbar spinal stenosis (LSS)?
  3. Does the ULBD surgery affect both sides of the back equally in terms of pain reduction?

Doctor’s Tip

A helpful tip a doctor might give to a patient undergoing a spinal laminectomy, especially a unilateral laminectomy for bilateral decompression, is to follow post-operative care instructions closely. This may include avoiding heavy lifting, bending, or twisting for a certain period of time, as well as participating in physical therapy to help strengthen the muscles supporting the spine. It’s important to listen to your body and not push yourself too hard too soon after surgery to ensure proper healing and reduce the risk of complications. Additionally, maintaining a healthy weight and staying active can help improve long-term outcomes after a spinal laminectomy.

Suitable For

Patients who are typically recommended spinal laminectomy include those with lumbar spinal stenosis (LSS) who have not responded to conservative treatments such as physical therapy, medications, and injections. Patients with symptoms such as lower back pain, leg pain, numbness, and weakness may benefit from this surgical procedure. Additionally, patients with significant narrowing of the spinal canal, causing compression of the nerves, may also be candidates for spinal laminectomy.

Timeline

Before the surgery:

  • Patient experiences symptoms of lumbar spinal stenosis, such as lower back pain, leg pain, and difficulty walking.
  • Patient undergoes diagnostic tests, such as X-rays, MRI, and physical examination, to confirm the diagnosis.
  • Patient and their healthcare provider discuss treatment options, including conservative measures like physical therapy and medication.
  • If conservative treatments are not effective, surgery may be recommended, and the patient undergoes pre-operative evaluations and consultations.

During the surgery:

  • The patient is placed under general anesthesia.
  • The surgeon makes an incision in the back and removes a portion of the lamina (the bony arch of the vertebra) to create more space in the spinal canal.
  • Any bone spurs or other structures compressing the nerves are also removed.
  • The incision is closed, and the patient is taken to the recovery room.

After the surgery:

  • Patient may experience some pain and discomfort at the surgical site.
  • Patient is monitored for complications, such as infection or nerve damage.
  • Patient undergoes physical therapy to strengthen the muscles supporting the spine and improve flexibility.
  • Patient gradually resumes normal activities, with restrictions on heavy lifting and strenuous exercise.
  • Follow-up appointments are scheduled to monitor the healing process and address any post-operative concerns.

What to Ask Your Doctor

  1. What is lumbar spinal stenosis (LSS) and how does it affect my spine?

  2. How does a unilateral laminectomy for bilateral decompression (ULBD) differ from traditional spinal decompression surgery?

  3. Are there any risks or complications associated with ULBD surgery?

  4. What is the success rate of ULBD in reducing lower back pain caused by LSS?

  5. How long is the recovery period after ULBD surgery?

  6. Will I need physical therapy or rehabilitation after the surgery?

  7. What activities should I avoid or modify to prevent further back pain after surgery?

  8. How long do the effects of ULBD surgery typically last?

  9. Are there any alternative treatments or therapies for LSS that I should consider before opting for surgery?

  10. What can I expect in terms of pain relief and mobility improvements after ULBD surgery?

Reference

Authors: Takahashi H, Aoki Y, Saito J, Nakajima A, Sonobe M, Akatsu Y, Inoue M, Taniguchi S, Yamada M, Koyama K, Yamamoto K, Shiga Y, Inage K, Orita S, Maki S, Furuya T, Koda M, Yamazaki M, Ohtori S, Nakagawa K. Journal: BMC Musculoskelet Disord. 2019 Mar 4;20(1):100. doi: 10.1186/s12891-019-2475-6. PMID: 30832643