317 Clinical Outcome of Transspinous Approach in Comparison With Conventional Laminectomy for Lumbar Degenerative Stenosis

Abstract INTRODUCTION: We aimed to evaluate the efficacy of the transspinous approach compared with the conventional laminectomy in degenerative lumber spinal stenosis with or without disc herniations. METHODS: Clinical data of the 198 patients, operated on between April 2011 and June 2015 for degenerative lumber spinal stenosis, were analyzed retrospectively. Patients were classified into 2 groups according to the type of surgery either conventional laminectomy (group I; 101 patients) or the transspinous approach (group II; 97 patients). Clinical outcome between the groups were assessed by comparing the length of inpatient hospital stay, postoperative pain, rate of postoperative neurological deficit and complications, and extent of decompression. RESULTS: Thirty-three patients in group I and 23 patients in group II underwent lumbar decompression with discectomy. Multilevel lumbar decompression was performed in 57 patients of group I and in 47 patients of group II. At postoperative pain evaluation, excellent, good, and fair outcomes were achieved in 77.4%, 16.9%, and 2.7% in group I and 79%, 18.9%, and 2.2% in group II, respectively. Satisfactory neurological decompression and symptom relief were achieved in 93% of these patients. Satisfactory decompression by means of increase in both mean spinal anteroposterior diameter and cross-sectional area were measured for transspinous approach when compared with the conventional laminectomy group. No statistically significant differences were identified in the rates of complications or length of inpatient hospital stay. CONCLUSION: Compared with conventional laminectomy, the transspinous decompression technique is an equally effective and minimal invasive technique in the treatment of degenerative lumbar stenosis with or without disc herniation.