Department of Orthopedic Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Department of Orthopedics, University of British Columbia, Vancouver, BC, Canada.
BMC Musculoskelet Disord. 2023 Nov 21;24(1):904. doi: 10.1186/s12891-023-07033-1.
Unilateral laminotomy with bilateral spinal canal decompression has gained popularity recently.
To systematically review the literature of unilateral laminotomy with bilateral spinal canal decompression for lumbar spinal stenosis (LSS) aiming to assess outcomes and complications of the different techniques described in literature.
On August 7, 2022, Pubmed and EMBASE were searched by 2 reviewers independently, and all the relevant studies published up to date were considered based on predetermined inclusion and exclusion criteria. The subject headings "unilateral laminotomy", "bilateral decompression" and their related key terms were used. The Preferred Reporting Item for Systematic Reviews and Meta-Analyses statement was used to screen the articles.
A total of seven studies including 371 patients were included. The mean age of the patients was 69.0 years (range: 55-83 years). The follow up duration ranged from 1 to 3 years. Rate of postoperative pain and functional improvement was favorable based on VAS, JOA, JOABPEQ, RMDW, ODI and SF-36, for example improved from a range of 4.2-7.5 preoperatively on the VAS score to a range of 1.4-3.0 postoperatively at the final follow up. Insufficient decompression was noted in 3% of the reported cases. The overall complication rate was reported at 18-20%, with dural tear at 3.6-9% and hematoma at 0-4%.
Unilateral laminotomy with bilateral decompression has favorable short- and mid-term pain and functional outcomes with low recurrence and complication rates. This, however, needs to be further confirmed in larger, long-term follow-up, prospective, comparative studies between open, and minimally invasive techniques.
单侧椎板切开双侧椎管减压术最近越来越受欢迎。
系统回顾单侧椎板切开双侧椎管减压术治疗腰椎管狭窄症（LSS）的文献，旨在评估文献中描述的不同技术的结果和并发症。
2022 年 8 月 7 日，2 名审查员独立检索 Pubmed 和 EMBASE，并根据预先确定的纳入和排除标准考虑所有已发表的相关研究。使用主题词“单侧椎板切开术”、“双侧减压术”及其相关关键词。使用系统评价和荟萃分析报告的首选报告项目来筛选文章。
共纳入 7 项研究，包括 371 例患者。患者的平均年龄为 69.0 岁（范围：55-83 岁）。随访时间从 1 年到 3 年不等。基于 VAS、JOA、JOABPEQ、RMDW、ODI 和 SF-36，术后疼痛和功能改善率是有利的，例如，VAS 评分从术前的 4.2-7.5 改善到最终随访时的 1.4-3.0。报告有 3%的病例存在减压不足。总的并发症发生率为 18-20%，其中硬脊膜撕裂占 3.6-9%，血肿占 0-4%。
单侧椎板切开双侧减压术具有良好的短期和中期疼痛和功能结果，复发率和并发症率低。然而，这需要在更大、长期随访、前瞻性、开放和微创技术之间的比较研究中进一步证实。
