title: En bloc partial laminectomy and posterior lumbar interbody fusion in foraminal spinal stenosis.
abstract: METHODS
  A retrospective study.
  
  
  OBJECTIVE
  An en bloc partial laminectomy and posterior lumbar interbody fusion (PLIF) in spinal stenosis patients with severe foraminal narrowing has a shorter operation time, less neural manipulation and allows indirect decompression by restoring the interforaminal height compared to other procedures. This study investigated the efficacy of the procedure.
  
  
  BACKGROUND
  PLIF is one of the most popular surgery for degenerative spine such as foraminal spinal stenosis, instability spondylolisthesis and discogenic pain. Various techniques for PLIF have their own advantages and disadvantages. But in some severe cases, we need an efficient method of PLIF for decompression and fusion.
  
  
  METHODS
  This study examined 61 patients, who had 85 levels treated with PLIF using an en bloc partial laminectomy and facetectomy, and could be followed up for more than 2 years. The mean age of the patients and mean follow up period was 66 years and 39 months, respectively. The clinical results were evaluated using the MacNab's criteria, Visual Analogue Scale (VAS) score, and Korea Version Oswestry Disability Index (KODI). The union of the intervertebral space was evaluated using Lenke's criteria. The intervertebral angle and height of the posterior intervertebral disc were also measured.
  
  
  RESULTS
  Excellent and good results were obtained in 54 cases (89%) according to MacNab's criteria. The VAS and KODI scores were 8.1 and 34.6, preoperatively, and 3.4, and 14.1, postoperatively. Bone union was A and B grades according to Lenke's criteria in 57 cases. The mean segmental angle and mean height of the posterior disc were respectively, 7.4 degrees and 6.5 mm preoperatively, 9.1 degrees and 10.6 mm postoperatively, and 8.0 degrees and 9.7 mm in the last follow-up. There were 5 cases of postoperative infection, 4 cases of junctional problems and 1 case of screw malposition.
  
  
  CONCLUSIONS
  En bloc partial laminectomy and PLIF is an effective method for treating severe spinal stenosis with foraminal narrowing.
authors.affiliation: Department of Orthopedic Surgery, Soonchunhyang University College of Medicine, Bucheon, Korea.
authors.forename: Eung-Ha
authors.initials: EH
authors.lastname: Kim
authors.forename: Hyung-Tae
authors.initials: HT
authors.lastname: Kim
references.citation: Acta Orthop Scand Suppl. 1993;251:78-80
references.pmid: 8451996
references.citation: Clin Orthop Relat Res. 1976 Mar-Apr;(115):122-9
references.pmid: 1253475
references.citation: Spine (Phila Pa 1976). 1996 Jan 1;21(1):92-8
references.pmid: 9122770
references.citation: J Spinal Disord. 1993 Dec;6(6):461-72
references.pmid: 8130395
references.citation: J Spinal Disord Tech. 2006 May;19(3):161-6
references.pmid: 16770211
references.citation: J Neurosurg. 1992 Nov;77(5):669-76
references.pmid: 1403105
references.citation: Clin Orthop Relat Res. 1986 Feb;(203):75-98
references.pmid: 3956000
references.citation: Clin Orthop Relat Res. 1986 Feb;(203):7-17
references.pmid: 3955999
references.citation: Spine (Phila Pa 1976). 2002 Feb 1;27(3):258-62
references.pmid: 11805688
references.citation: Spine (Phila Pa 1976). 1987 Mar;12(2):97-104
references.pmid: 2954220
references.citation: Spine (Phila Pa 1976). 2000 Apr 1;25(7):853-7
references.pmid: 10751297
references.citation: Neurosurgery. 2002 Nov;51(5 Suppl):S146-54
references.pmid: 12234442
references.citation: J Bone Joint Surg Am. 1991 Jul;73(6):809-16
references.pmid: 2071616
references.citation: J Spinal Disord. 1992 Dec;5(4):433-42
references.pmid: 1490041
references.citation: Spine (Phila Pa 1976). 2003 Aug 1;28(15 Suppl):S26-35
references.pmid: 12897471
references.citation: Surg Neurol. 2000 Jan;53(1):2-6; discussion 6-7
references.pmid: 10697227
references.citation: Spine (Phila Pa 1976). 1999 May 15;24(10):1043-7
references.pmid: 10332799