Comparison of techniques for decompressive lumbar laminectomy: the minimally invasive versus the "classic" open approach.
OBJECTIVE
Decompressive laminectomy offers an effective surgical treatment of lumbar spinal stenosis. The purpose of this study was to compare the elements of treatment commonly associated with successful outcomes in the assessment of laminectomies - operating room times, estimated blood loss, length of stay, and complications - of the minimally invasive and open approach laminectomies.


METHODS
We retrospectively reviewed the medical records and relevant imaging of 126 patients who underwent surgical decompression for lumbar stenosis. Thirty-eight patients underwent bilateral decompression via a unilateral minimally invasive technique, while 88 patients underwent bilateral decompression via a standard open technique. A chart review was performed to determine intraoperative blood loss, length of operative time, length of hospital stay, and number and nature of complications.


RESULTS
The minimally invasive lumbar laminectomy (MID) patients had shorter operating room times, less estimated blood loss, shorter length of stay, and fewer complications.


CONCLUSIONS
Bilateral decompression of lumbar spinal stenosis via a unilateral approach involves shorter operating times and less blood loss, less muscle dissection, fewer and less severe complications, and better mobility in the immediate postoperative period than open decompressive techniques. In addition, this technique is very similar to the commonly performed microendoscopic discectomy and is easily mastered over time.
Rahman
M
M
Department of Neurological Surgery, McKnight Brain Institute, University of Florida, Gainesville, FL 32610, USA.
Summers
L E
LE
Richter
B
B
Mimran
R I
RI
Jacob
R P
RP
D000368:Aged; D019299:Decompression, Surgical / Q000379:methods*; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D007902:Length of Stay; D017843:Ligamentum Flavum / Q000473:pathology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000033:anatomy & histology / Q000473:pathology / Q000601:surgery; D008866:Microsurgery / Q000295:instrumentation / Q000379:methods; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D011843:Radiculopathy / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D013115:Spinal Canal / Q000033:anatomy & histology / Q000473:pathology / Q000601:surgery*; D013130:Spinal Stenosis / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000473:pathology / Q000601:surgery