Department of Orthopaedic Surgery, College of Medicine, Daegu Catholic University, 33, Duryugongwon-ro 17-gil, Nam-gu, Daegu, 42472, South Korea.
J Orthop Surg Res. 2019 Aug 8;14(1):252. doi: 10.1186/s13018-019-1298-3.
Conventional posterior open lumbar surgery is associated with considerable trauma to the paraspinal muscles. Severe damage to the paraspinal muscles could cause low back pain (LBP), resulting in poor functional outcomes. Thus, several studies have proposed numerous surgical techniques that can minimize damage to the paraspinal muscles, particularly unilateral laminotomy for bilateral decompression. The purpose of this study is to compare the degree of postoperative LBP, functional outcome, and quality of life of patients between bilateral decompression via unilateral laminotomy (BDUL; group U) and conventional laminectomy (CL; group C).
Of 87 patients who underwent diagnostic and decompression surgery, 50 patients who met the inclusion and exclusion criteria and were followed up for > 2 years were enrolled. The patients were asked to record their visual analog scale pain score after 6, 12, and 24 months postoperatively. BDUL was used for group U, whereas CL was used for group C. The patients were randomly divided based on one of the two techniques, and they were followed up for over 2 years. Functional outcomes were assessed by the Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), and SF-36.
Operation time was significantly shorter in group U than in group C (p = 0.003). At 6, 12, and 24 months, there was no significant difference between the two groups in terms of spine-related pain (all p > 0.05). Functional outcomes using ODI and RMDQ and quality of life using SF-36 were not significantly different between the groups (all p > 0.05).
Regarding single-level decompression for degenerative lumbar spinal stenosis, group U had the advantages of shorter operation time than group C, but not in terms of back pain, functional outcome, and quality of life.
传统的后路腰椎开放手术会对腰背肌造成相当大的创伤。腰背肌的严重损伤可导致腰痛（LBP），从而导致功能预后不良。因此，许多研究提出了许多可以最大限度减少腰背肌损伤的手术技术，特别是用于双侧减压的单侧椎板切开术。本研究的目的是比较单侧椎板切开双侧减压（BDUL；U 组）与传统椎板切除术（CL；C 组）术后 LBP 程度、功能结局和生活质量。
对 87 例接受诊断和减压手术的患者进行分析，其中 50 例符合纳入和排除标准并随访>2 年的患者被纳入研究。患者在术后 6、12 和 24 个月时记录视觉模拟评分（VAS）疼痛评分。U 组采用 BDUL，C 组采用 CL。患者根据其中一种技术随机分组，随访时间超过 2 年。功能结局采用 Oswestry 功能障碍指数（ODI）、Roland-Morris 残疾问卷（RMDQ）和 SF-36 进行评估。
U 组的手术时间明显短于 C 组（p = 0.003）。在 6、12 和 24 个月时，两组间脊柱相关疼痛无显著差异（均 p>0.05）。ODI 和 RMDQ 功能结局以及 SF-36 生活质量评分两组间无显著差异（均 p>0.05）。
对于单节段退行性腰椎管狭窄症，U 组手术时间比 C 组短，但在腰痛、功能结局和生活质量方面并无优势。
