Journal of Surgery. 2014, 2(1), 7-11DOI:
Abstract: Background: In some patients with refractory lumbar spinal stenosis (LSS) surgical decompression is necessary. However, a fear of iatrogenic instability has always been associated with extensive decompression. In this study, we aim to evaluate the surgical outcomes of laminotomy versus laminectomy in the geriatric patients with multilevel LSS. Methods: We retrospectively evaluated 79 (29 male and 50 female) geriatric patients with multilevel degenerative but stable LSS from August 2008 to September 2011. The mean age and follow-up period was 74 ± 12.1 (ranged; 65 to 83 years old) and 34 ± 6.5 (ranged; 25 to 51 months), respectively. We placed our patients into two groups; A: laminotomy (44 cases) and B: laminectomy (35 patients). Preoperatively and at the last follow-up visit, the patients were assessed by visual analogue scale (VAS) and Oswestry disability index (ODI). Satisfaction rate was also recorded. Then, an intra- and postoperative comparison between these two techniques was carried out, statistically. Results: No significant differences existed between the two groups in terms of sex distribution, age and duration of follow-up. Intergroup comparison showed that patient satisfaction rate and the mean improvement in VAS and ODI was comparable. Mean blood loss and operating time were both greater in laminotomy group but only the latter was statistically significant. Conclusions: In geriatric patients more than 65 years old with multilevel but stable degenerative LSS, due to its more simplicity and less operative time, we still prefer and recommend laminectomy versus laminotomy.