Comparison of Three Different Paraspinous Unilateral Approaches to the Spinal Canal for Lumbar Decompression-Minimally 2-Year Postoperative EvaluationMasahiro Morita1* and Hiroaki Nakamura2
- *Corresponding Author:
- Masahiro Morita
Department of Orthopaedic Surgery
Izumi Municipal Hospital, Japan
Fax: +81-725-43-3350 E-mail: [email protected]
Received date: July 26, 2017; Accepted date: August 01, 2017; Published date: August 06, 2017
Citation: Morita M, Nakamura H (2017) Comparison of Three Different Paraspinous Unilateral Approaches to the Spinal Canal for Lumbar Decompression-Minimally 2-Year Postoperative Evaluation. J Spine 6:381. doi:10.4172/2165-7939.1000381
Copyright: © 2017 Morita M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: The purpose of this study is to investigate the differences of the clinical results and imaging findings among three different bilateral decompression via unilateral approach with a minimum 2-year follow-up period.
Methods: Thirty consecutive patients with lumbar spinal canal stenosis who had undergone bilateral decompression via 3 different unilateral paraspinous approaches with a minimum 2-year follow-up period were chosen retrospectively for groups A (conventional open surgery), B (mini open surgery), and C (micro-endoscopic surgery). The clinical results and imaging findings of these three groups were then investigated.
Results: A significant difference in length of incision and intraoperative blood loss per level decompressed was seen with group A>B>C. Operative time per level decompressed was longer in group C than in groups A or B. Japanese Orthopaedic Association (JOA) score recovery rate was lower in group B than in group C. The change ratios of cross-sectional area (CSA) of the ipsilateral and contralateral multifidus were smaller in group A than in groups B or C. Ipsilateral facet joint preservation was less in group A than group C, and contralateral facet joint preservation was less in group A than in groups B or C. The difference in change in slippage was greater in group A than in group C.
Conclusion: This study revealed that bilateral decompression via a unilateral approach using mini open or microendoscopic procedures could be better surgical interventions compared to a conventional unilateral open approach for paravertebral muscle and facet joint preservation for at least 2 years.