Comparison of Bilateral Laminectomy with Unilateral Approach and Open Bilateral Laminectomy in Lumbar Spinal Stenosis

Abstract

Amaç: Lomber spinal kanal darlığı (LSKD), dekompresyon cerrahisi gerektiren sık görülen bir durumdur, ancak tedavide farklı cerrahi yaklaşımlar vardır. Bu çalışmanın amacı, tek seviyeli LSKD için tek taraflı yaklaşımla iki taraflı dekompresif lomber laminektomi (TYİDL) açık iki taraflı dekompresif lomber laminektominin (AiDL) sonuçlarını karşılaştırmaktır. Yöntem: Ekim 2016 ile Mayıs 2023 arasında tek seviyeli LSS için operasyon geçiren 198 ardışık hasta retrospektif olarak değerlendirildi. Seksen hastaya TYİDL, 118 hastaya AiDL uygulandı. Tüm hastalarda ameliyat öncesi ve 6 ay sonrasında Visual Analog Skala (VAS) skorları ve yürüme süreleri kaydedildi. Operasyon süresi, operasyon komplikasyonları, hastanede kalış süresi, operasyon sırasındaki kan kaybı ve iatrojenik spondilolistezis oranları ölçüldü. Bulgular: Çalışmaya dahil edilen hastaların yaş ortalaması 62.38±12.5 yıldı. TYİDL ve AiDL geçiren hastalar arasında VAS skorları, yürüme süreleri, ameliyat süreleri, ameliyat komplikasyonları ve takiplerinde iatrojenik spondilolistezis açısından istatistiksel olarak anlamlı bir fark yoktu (p > 0.05). Ancak, TYİDL geçiren hastalarda operasyon sırasındaki toplam kan kaybı ve hastanede kalış süresi, AİDL geçiren hastalara göre anlamlı olarak daha kısaydı (p<0.05). Sonuç: TYİDL ve AİDL uygulanan hastalar, operasyon komplikasyonları, VAS skorları, operasyon süresi ve takipteki iatrojenik spondilolistezis oranları açısından benzer sonuçlar gösterdi. Ancak, hastanede kalış süresi ve operasyon sırasındaki kan kaybı miktarı, TYİDL uygulanan hastalarda anlamlı olarak daha kısaydı. Anahtar Kelimeler: Lomber laminektomi, Spinal dar kanal, Tek taraflı yaklaşım

Keywords

• Lumbar lamicectomy,
• Spinal stenosis
• Unilateral approach

Ethical Statement

.This study was approved by the Clinical Research Ethics Committee, Balıkesir University Faculty of Medicine, (Decision No. 2023/164, Date: 22/11/2023).

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