Item type:Thesis, Open Access

Monosegmentale, degenerativ erworbene Spinalkanalstenose: Unilaterale Dekompression versus unilaterale Dekompression mit Undercutting der Gegenseite bei beidseitiger Symptomatik

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2017-02-23

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Philipps-Universität Marburg
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Abstract

Study Design: Retrospective comparative study
 Objective: To compare retrospectively postoperative changes in function, pain and contentedness of two different types of minimal invasive surgical methods for bilateral lum- bar spinal canal stenosis (BLSCS): unilateral decompression with contralateral undercutting (ULBD*, Group 1) and unilat- eral laminotomy for symptomatic, bilateral spinal stenosis (ULBD, Group 2).
 Summary of Background Data: Although previous studies have reported several procedures of minimal invasive surgery for the treatment of BLSCS, no article has compared two minimal in- vasive procedures for BLSCS using an overall score combining contentedness, function and pain.
 Methods: We collected data from 103 patients between 2006 and 2008. A total of 42 patients were treated with ULBD* while the remaining 61 patients underwent ULBD. All 103
patients were assessed within three and a half years after the operation. The shortest follow up time was eight months. The patients’ symptoms were evaluated using the functional scores: Oswestry Disability Score (ODS), Roland Morris Score (RMS) and walking capacity pre and post operation. Pain was graded by changes of the Visual Analogue Scale (VAS) for leg pain (lp) and back pain (bp) pre and post operation and post operation satisfaction. Success rate was determined using an universal overall score combining the three most important values con- cerning BLSCS. We used the most common threshold values for minimal clinical differences found within the literature (satisfac- tion: 7, function (RMS): 5 and pain (VAS lp): 1.5).
 Results: Patients from both groups were on average content with the results of the operation. Pre post operation compari- sons within both groups identified improvements in function, pain and walking capacity. There was a difference in walking capacity between the two groups post operation, the walking distance in group 1 was higher than in group 2. Success rate, defined by the overall score was 85% in group 1 and 56% in group 2, however patients from group 1 had a significantly better outcome. Multivariate binary logistic regression showed that group 1 had a better chance of achieving the overall score threshold than the group 2 by a factor of three. Conclusion: Both ULBD and ULBD* were efficient procedures for improving functional and neurological symptoms in pa- tients with BLSCS. In the overall score and walking capacity ULBD* was superior to ULBD in the first 3,5 years after the operation.

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Dates
Created: 2017Issued: 2017-02-23Updated: 2017-02-23
DOI
https://doi.org/10.17192/z2017.0141
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
SpinalkanalstenoseUnilaterale Dekompressionbilateral symptomaticspinal StenosisBilaterale Symptomatikunilateral decompression
DFG-subjects
Bilaterale SymptomatikUnilaterale DekompressionSpinalkanalstenose
DDC-Numbers
610
License
https://creativecommons.org/licenses/by-nc-nd/4.0/
URI
https://open.uni-marburg.de/handle/10.17192/z2017.0141
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Waldron, Lea Sibylle: Monosegmentale, degenerativ erworbene Spinalkanalstenose: Unilaterale Dekompression versus unilaterale Dekompression mit Undercutting der Gegenseite bei beidseitiger Symptomatik. : Philipps-Universität Marburg 2017-02-23. DOI: https://doi.org/10.17192/z2017.0141.

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Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 - CC BY NC ND
Except where otherwised noted, this item's license is described as Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 - CC BY NC ND