Our Summary

This study looked at the effects of different types of surgery on patients suffering from lumbar spinal stenosis (LSS), a condition that causes narrowing of the spinal canal and can result in nerve compression and pain. Researchers compared two types of surgery - single-level decompressive laminectomy and multilevel decompressive laminectomy.

A laminectomy is a surgery that removes part of a vertebra to relieve pressure on the spinal cord or nerves. A single-level laminectomy removes part of one vertebra, while a multilevel laminectomy removes part of several vertebrae.

The study included 112 patients who underwent one of these surgeries between March 2010 and September 2013. Researchers measured patients’ disability scores, pain levels, and walking duration before and 30 months after the surgery.

The results showed that patients who underwent single-level surgery had better outcomes in terms of less disability, less pain, and longer walking duration. However, there was no significant difference in the number of complications between the two types of surgery.

Four patients who underwent multilevel surgery experienced a condition called spondylolisthesis, where one of the vertebrae slips out of place, after the surgery and required additional surgery.

In conclusion, the study suggests that patients with LSS might have better outcomes with single-level laminectomy compared to multilevel laminectomy.

FAQs

  1. What is a laminectomy and what’s the difference between a single-level and a multilevel laminectomy?
  2. What were the results of the study comparing single-level and multilevel laminectomy surgeries for patients with lumbar spinal stenosis?
  3. What is spondylolisthesis and how is it related to multilevel laminectomy surgery?

Doctor’s Tip

A doctor might tell a patient considering a spinal laminectomy that a single-level laminectomy may provide better outcomes in terms of disability, pain relief, and walking ability compared to a multilevel laminectomy. Additionally, patients should be aware of the potential risk of developing spondylolisthesis after multilevel surgery, which may require additional surgery. It is important for patients to discuss the risks and benefits of each type of surgery with their doctor to make an informed decision about their treatment.

Suitable For

Patients who are typically recommended for spinal laminectomy are those suffering from lumbar spinal stenosis (LSS) who have not responded well to conservative treatments such as physical therapy, medications, or injections. These patients may experience symptoms such as lower back pain, leg pain, numbness, weakness, and difficulty walking due to nerve compression in the spinal canal. Additionally, patients with severe symptoms, progressive neurological deficits, or significant functional limitations may also be recommended for spinal laminectomy surgery.

Timeline

Before the surgery, the patient would have been experiencing symptoms such as back pain, leg pain, numbness or weakness in the legs, difficulty walking, and possibly loss of bladder or bowel control. They would have undergone diagnostic tests such as X-rays, MRI, or CT scans to confirm the diagnosis of lumbar spinal stenosis.

After the surgery, the patient would typically experience some pain and discomfort at the surgical site, which can be managed with pain medication. Physical therapy may be recommended to help with recovery and improve strength and flexibility. Over time, the patient should experience improvement in their symptoms, with reduced pain, improved mobility, and better quality of life. It may take several weeks to months for full recovery and return to normal activities. Follow-up appointments with the surgeon would be scheduled to monitor progress and address any issues that may arise.

What to Ask Your Doctor

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

  1. What are the benefits of single-level laminectomy compared to multilevel laminectomy for my specific condition?
  2. What are the potential risks and complications associated with each type of surgery?
  3. What is the expected recovery time and rehabilitation process for each type of surgery?
  4. How will my pain levels, disability scores, and walking duration be affected by the surgery?
  5. Are there any alternative treatment options to consider before undergoing a laminectomy?
  6. What is the success rate of each type of surgery in relieving symptoms of lumbar spinal stenosis?
  7. Will I require additional surgery in the future if I choose multilevel laminectomy?
  8. How many of these surgeries have you performed, and what is your success rate?
  9. What is the long-term outlook for patients who undergo single-level laminectomy versus multilevel laminectomy?
  10. Can you provide me with any patient testimonials or references who have undergone similar surgeries with successful outcomes?

Reference

Authors: Adilay U, Guclu B. Journal: World Neurosurg. 2018 Mar;111:e235-e240. doi: 10.1016/j.wneu.2017.12.033. Epub 2017 Dec 16. PMID: 29258933