Stenotic conditions of the lumbar spinal canal: changes in surgical techniques in the management of low back disability.

The diagnostic recognition of acquired stenotic conditions in the lumbar spinal canal occurring from the fifth to the eighth decades of life had led to a significant change in surgical techniques during the last ten years. This communication presents a comparison of surgical techniques used by the author in two consecutive series of patients operated for low back, lumbosciatic, and spondylotic caudal disability syndromes during the period 1965 to 1969 inclusive (100 patients) and 1976 and 1977 (105 patients). Interlaminar discectomy was carried out in 88%, and laminectomy with spinal nerve nerolysis in 12%, of the 1965 - 1969 series. Discectomy by interlaminar approach was carried out in only 10% of the 1976 - 1977 series; all other patients had laminectomies with or without discectomies. Early follow-up results in the recent series indicate a significant (20%) increase in the number of patients who resumed their previous occupations as compared with those in the previous series.