Japanese Surgeons Report New Technique for LaminectomyIn a standard operation for lumbar canal stenosis (LCS) the muscles alongside the spine are cut and pulled away from the bone. This allows the surgeon better access to the spine to cut away some of the bone pressing on vital nerve tissue. In this study surgeons from Tokyo, Japan use a new technique that doesn't involve cutting away the muscles.
The new method is called lumbar spinous process-splitting laminectomy (LSPSL). The backbone along the spine (spinous process) is split in half. The muscles and ligaments attached to the spinous process remain untouched. The surgeon separates the spinous process into two halves and pulls them out of the way. Then the laminectomy is performed. At the end the two parts of the bone are sewn back together.
The outcomes for two groups of patients were compared. Group one had the standard or conventional operation. Group two had the new LSPSL method. Measures used to compare results included muscle atrophy and recovery rate. Everyone was followed for at least two years.
The MRI results showed much better muscle definition and size in the LSPSL group. Atrophy was reported as 5.3 percent for the LSPSL group compared to 24 percent for the standard (control) group.
Surgical damage to the back muscles is a problem with laminectomy. The LSPSL method gives the surgeon a better view and more working space to gain access to the nerves. At the same time the LSPSL minimizes damage to the soft tissue supporting structures of the spine. Long-term results are needed before this method can be adopted.
Kota Watanabe, MD, et al. Lumbar Spinous Process -- Splitting Laminectomy for Lumbar Canal Stenosis. Technical Note. In Journal of Neurosurgery: Spine. November 2005. Vol. 3. No. 5. Pp. 405-408.
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