Abstract

Background data: Central Decompressive Laminoplasty (CDL) is a minimally invasive lumbar surgery that provides a wide decompression of neural components while maintaining the spine’s stability and minimal resection of critical osteoligamentous structures. Purpose: The present study aims to assess the outcome and long-term results of CDL in the treatment of patients with degenerative lumbar canal stenosis regarding post-operative spinopelvic parameters, symptom relief, postoperative back pain, and wound complications. Study design: Patient Sample, Outcome Measures: A retrospective study was conducted over 30 patients and carried out at Zagazig university Hospital, Spine units, Orthopedic department, from October 2019 to May 2021. Patients and methods: Pre-operative radiological assessment was done using standing lumbosacral X-rays (anteroposterior, lateral, flexion and extension views), MRI, and/or CT, with obtaining following parameters using the Surgimap computer program; Spino-pelvic parameters using X-ray, AP Dural sac diameter (mm), Dural Sac Cross-Sectional Area (DSCSA) (mm2). Clinical evaluation was done with (VAS), and the Oswestry Disability Index (ODI). Result: The study showed no significant change in spinal stability, the mean pre-operative PT, PI, SS and LL were 20.81±6.58°, 49.31±12.54°, 29.37±4.32° and 35.44±12.36° respectively, while the post-operative PT, PI, SS, and LL were 21.10±5.79°, 51.30±11.69°, 30.86±5.81° and 37.69±9.82° respectively. The study showed improvement of VAS from 8.16±0.71 to 1.20±0.41 showing 84.5% improvement, while VAS of low back pain improved from 4.33±1.07 to 1.75±0.62 showing 59.5% improvement. The mean anteroposterior thecal diameter improved from 6.54±1.2mm to 12.79±1.6mm with 95.6% improvement. Conclusion: CDL is a safe, effective, less invasive, and easily applied surgical decompressive technique for treating degenerative LSS. The technique does not affect the spinopelvic parameters negatively.

Keywords:Lumbar canal stenosis; Low back pain; Outcomes; Degenerative; Treatment; Laminoplasty; Minimal invasive; Decompression

Abbreviations:LSS: Lumbar Spinal Stenosis; C7PL: The Seventh Cervical Vertebral Plumb Line; CDL: Central Decompressive Laminoplasty; VAS: Visual Analog Scale; ODI: Oswestry Disability Index; PT: Pelvic Tilt; PI: Pelvic Incidence; SS: Sacral Slope