title: Microscopic bilateral decompression through unilateral laminotomy for lumbar canal stenosis in patients undergoing hemodialysis.
abstract: OBJECTIVE
  Microscopic bilateral decompression through a unilateral laminotomy (MBDUL) is a minimally invasive technique used to treat lumbar canal stenosis (LCS). In the present study, MBDUL was performed to treat LCS in eight patients undergoing hemodialysis.
  
  
  METHODS
  Surgical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) scale (highest possible score 29). The JOA scale was administered preoperatively, at 1 month and 3 months postoperatively, and at the final follow-up examination. One patient refused to undergo the postoperative assessment after the 1-month examination; the mean follow-up duration of the remaining seven patients was 24 months (range 18-31 months). The mean age at the time of surgery was 62 years (range 48-76 years), and the mean duration of hemodialysis therapy was 21.4 years (range 3-28 years). All patients could walk within 2 days of surgery. The mean angle of the straight leg-raising (SLR) test was 53.8 degrees preoperatively, and this increased to 69.4 degrees postoperatively. Six patients felt enhancement of sciatica or leg pain when performing the SLR test preoperatively, a finding that was absent postoperatively at least until the final follow-up examination. The mean preoperative JOA score was 11.6 (range 4-22), and the score markedly improved to 19.8 (range 15-23) at 1 month and 20.6 (range 16-25) at 3 months. The mean JOA score decreased to 17.1 (range 12-25) at the final follow-up examination, but this decrease was attributed to other physical disorders.
  
  
  CONCLUSIONS
  The authors conclude that MBDUL is a safe and effective surgical treatment for patients undergoing hemodialysis who are suffering from LCS.
authors.affiliation: Department of Neurosurgery, Yukioka Hospital, Osaka City, Japan. mana-nsu@umin.ac.jp
authors.forename: Manabu
authors.initials: M
authors.lastname: Sasaki
authors.forename: Makoto
authors.initials: M
authors.lastname: Abekura
authors.forename: Shayne
authors.initials: S
authors.lastname: Morris
authors.forename: Chihiro
authors.initials: C
authors.lastname: Akiyama
authors.forename: Kazuya
authors.initials: K
authors.lastname: Kaise
authors.forename: Takamichi
authors.initials: T
authors.lastname: Yuguchi
authors.forename: Shintaro
authors.initials: S
authors.lastname: Mori
authors.forename: Koichi
authors.initials: K
authors.lastname: Iwatsuki
authors.forename: Toshiki
authors.initials: T
authors.lastname: Yoshimine
mesh_terms: D000368:Aged; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D007796:Laminectomy / Q000379:methods*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D006435:Renal Dialysis; D013130:Spinal Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome