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Clinical and Radiological Comparison between Ipsilateral and Contralateral Side Canal Decompression Using an Unilateral Laminotomy Approach

OBJECTIVE: To compare the clinical and radiological outcome of both sides using the unilateral approach. METHODS: Unilateral laminotomy was performed to achieve bilateral decompression. Thirty-nine patients who underwent this procedure were analyzed prospectively using the Oswestry Disability Index...

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Autores principales: Park, Woong Bae, Hong, Jae Taek, Lee, Sang Won, Sung, Jae Hoon, Yang, Seung Ho, Kim, IL Sub
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Spinal Neurosurgery Society 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4949165/
https://www.ncbi.nlm.nih.gov/pubmed/27437011
http://dx.doi.org/10.14245/kjs.2016.13.2.41
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author Park, Woong Bae
Hong, Jae Taek
Lee, Sang Won
Sung, Jae Hoon
Yang, Seung Ho
Kim, IL Sub
author_facet Park, Woong Bae
Hong, Jae Taek
Lee, Sang Won
Sung, Jae Hoon
Yang, Seung Ho
Kim, IL Sub
author_sort Park, Woong Bae
collection PubMed
description OBJECTIVE: To compare the clinical and radiological outcome of both sides using the unilateral approach. METHODS: Unilateral laminotomy was performed to achieve bilateral decompression. Thirty-nine patients who underwent this procedure were analyzed prospectively using the Oswestry Disability Index (ODI), the visual analog scale (VAS) pain score to evaluate symptoms in both legs, and the radiological morphometric index to calculate the anteriorposterior diameter and midcanal width. The incidence of complications from this approach was then evaluated. RESULTS: The mean follow-up time was 12.2 months. The mean ODI was 48.4 preoperatively and 14.2 postoperatively. The mean dural sac widening of the ipsilateral side (187.0%) was significantly larger (p<0.01) than that of the the contralateral side (145.6%). The VAS improvement ratio ([preoperative VAS score-postoperative VAS score]/[preoperative VAS score]×100) for the pain in each leg was 75.4%(ipsilateral side) and 73.7%(contralateral side). While the VAS improvement ratio for pain in each side was significantly reduced, the difference in the VAS ratio between sides was statistically insignificant (p=0.64). There were 2 cases (5.1%) of dural tearing during the procedure, 1 case (2.6%) of transient paresthesia of nerve roots, and 2 cases (5.1%) of transient paresthesia of the contralateral nerve root. The transient paresthesias of nerve roots never lasted more than 2 weeks. CONCLUSION: This technique allows for significant decompression of the contralateral canal and excellent clinical outcomes without troublesome complications. Although ipsilateral the dural sac widening was significantly larger than contralateral side, the difference in the clinical outcome between sides was statistically insignificant.
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spelling pubmed-49491652016-07-19 Clinical and Radiological Comparison between Ipsilateral and Contralateral Side Canal Decompression Using an Unilateral Laminotomy Approach Park, Woong Bae Hong, Jae Taek Lee, Sang Won Sung, Jae Hoon Yang, Seung Ho Kim, IL Sub Korean J Spine Clinical Article OBJECTIVE: To compare the clinical and radiological outcome of both sides using the unilateral approach. METHODS: Unilateral laminotomy was performed to achieve bilateral decompression. Thirty-nine patients who underwent this procedure were analyzed prospectively using the Oswestry Disability Index (ODI), the visual analog scale (VAS) pain score to evaluate symptoms in both legs, and the radiological morphometric index to calculate the anteriorposterior diameter and midcanal width. The incidence of complications from this approach was then evaluated. RESULTS: The mean follow-up time was 12.2 months. The mean ODI was 48.4 preoperatively and 14.2 postoperatively. The mean dural sac widening of the ipsilateral side (187.0%) was significantly larger (p<0.01) than that of the the contralateral side (145.6%). The VAS improvement ratio ([preoperative VAS score-postoperative VAS score]/[preoperative VAS score]×100) for the pain in each leg was 75.4%(ipsilateral side) and 73.7%(contralateral side). While the VAS improvement ratio for pain in each side was significantly reduced, the difference in the VAS ratio between sides was statistically insignificant (p=0.64). There were 2 cases (5.1%) of dural tearing during the procedure, 1 case (2.6%) of transient paresthesia of nerve roots, and 2 cases (5.1%) of transient paresthesia of the contralateral nerve root. The transient paresthesias of nerve roots never lasted more than 2 weeks. CONCLUSION: This technique allows for significant decompression of the contralateral canal and excellent clinical outcomes without troublesome complications. Although ipsilateral the dural sac widening was significantly larger than contralateral side, the difference in the clinical outcome between sides was statistically insignificant. The Korean Spinal Neurosurgery Society 2016-06 2016-06-30 /pmc/articles/PMC4949165/ /pubmed/27437011 http://dx.doi.org/10.14245/kjs.2016.13.2.41 Text en Copyright © 2016 The Korean Spinal Neurosurgery Society http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Article
Park, Woong Bae
Hong, Jae Taek
Lee, Sang Won
Sung, Jae Hoon
Yang, Seung Ho
Kim, IL Sub
Clinical and Radiological Comparison between Ipsilateral and Contralateral Side Canal Decompression Using an Unilateral Laminotomy Approach
title Clinical and Radiological Comparison between Ipsilateral and Contralateral Side Canal Decompression Using an Unilateral Laminotomy Approach
title_full Clinical and Radiological Comparison between Ipsilateral and Contralateral Side Canal Decompression Using an Unilateral Laminotomy Approach
title_fullStr Clinical and Radiological Comparison between Ipsilateral and Contralateral Side Canal Decompression Using an Unilateral Laminotomy Approach
title_full_unstemmed Clinical and Radiological Comparison between Ipsilateral and Contralateral Side Canal Decompression Using an Unilateral Laminotomy Approach
title_short Clinical and Radiological Comparison between Ipsilateral and Contralateral Side Canal Decompression Using an Unilateral Laminotomy Approach
title_sort clinical and radiological comparison between ipsilateral and contralateral side canal decompression using an unilateral laminotomy approach
topic Clinical Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4949165/
https://www.ncbi.nlm.nih.gov/pubmed/27437011
http://dx.doi.org/10.14245/kjs.2016.13.2.41
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