Open Laminectomy for Lumbar Spinal Canal Stenosis due to Prolapsed Lumbar Intervertebral Discs.

BACKGROUND

Back pain due to prolapsed intervertebral disc accounts for two thirds of all visits to the orthopaedic clinic. The incidence of this disease is increasing with the increased sports activities in the young and due to degeneration in the elderly. Open lumbar microdiscectomy remains the gold standard amongst surgical procedures for herniated discs with or without instrumentation. However, percutaneous/ endoscopic microdiscectomy is gaining popularity. In our environment, high cost and paucity of instrumentation and skills militate against the use of such technique. In the western world, improvement in the mentioned skills and instrumentation and shorter rehabilitation time make minimal access surgeries more appealing than open microdiscectomy in recent times.

MATERIALS AND

METHODS

Patients with clinical signs and symptoms of spinal canal stenosis secondary to isolated lumbar disc herniation were investigated with plain radiographs and magnetic resonance imaging (MRI). All those with definite canal stenosis as seen on the MRI that were not responsive to conservative therapy or those with rapidly deteriorating clinical outlook without instability were included to have open Laminectomy without instrumentation. Their preoperative and postoperative walking distance, their modified Roland-Morris disability indices, Their pain numeric score (NRS), their anteroposterior distance of the spinal canal at maximal site of stenosis and finally the absence or presence of preoperative and post operative anteroposterior/instability.

RESULTS

Twenty patients had open Laminectomy. There was significant improvement in the postoperative pain numeric score, the walking distance, the Roland Morris disability score. There was no evidence of postoperative instability on the plain radiograph.

CONCLUSION

Open Laminectomy remains a useful tool in the treatment of patients with lumbar spinal canal stenosis due to prolapsed intervertebral discs.