title: Comparison of Spinous Process-Splitting Laminectomy versus Conventional Laminectomy for Lumbar Spinal Stenosis.
abstract: METHODS
  Seventy-five patients who had been treated for lumbar spinal stenosis (LSS) were reviewed retrospectively.
  
  
  OBJECTIVE
  Invasion into the paravertebral muscle can cause major problems after laminectomy for LSS. To address these problems, we performed spinous process-splitting laminectomy. We present a comparative study of decompression of LSS using 2 approaches.
  
  
  BACKGROUND
  There are no other study has investigated the lumbar spinal instability after spinous process-splitting laminectomy.
  
  
  METHODS
  This study included 75 patients who underwent laminectomy for the treatment of LSS and who were observed through follow-ups for more than 2 years. Fifty-five patients underwent spinous process-splitting laminectomy (splitting group) and 20 patients underwent conventional laminectomy (conventional group). We evaluated the clinical and radiographic results of each surgical procedure.
  
  
  RESULTS
  Japanese Orthopaedic Association score improved significantly in both groups two years postoperatively. The following values were all significantly lower, as shown with p-values, in the splitting group compared to the conventional group: average operating time (p=0.002), postoperative C-reactive protein level (p=0.006), the mean postoperative number of days until returning to normal body temperature (p=0.047), and the mean change in angulation 2 years postoperatively (p=0.007). The adjacent segment degeneration occurred in 6 patients (10.9%) in the splitting group and 11 patients (55.0%) in the conventional group.
  
  
  CONCLUSIONS
  In this study, the spinous process-splitting laminectomy was shown to be less invasive and more stable for patients with LSS, compared to the conventional laminectomy.
authors.affiliation: Department of Orthopaedic Surgery, Yodakubo Hospital, Nagawa-machi, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Uehara
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Takahashi
authors.affiliation: Department of Orthopaedic Surgery, Shinonoi General Hospital, Nagano, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hashidate
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Keijiro
authors.initials: K
authors.lastname: Mukaiyama
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Shugo
authors.initials: S
authors.lastname: Kuraishi
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Shimizu
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Shota
authors.initials: S
authors.lastname: Ikegami
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Futatsugi
authors.affiliation: Department of Orthopaedic Surgery, Ina Central Hospital, Ina, Japan.
authors.forename: Nobuhide
authors.initials: N
authors.lastname: Ogihara
authors.affiliation: Department of Orthopaedic Surgery, Marunouchi Hospital, Matsumoto, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hirabayashi
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kato
keywords: Lumbar spinal stenosis; Paravertebral muscle, posterior approach; Postoperative low back pain; Spinous process-splitting laminectomy