Trumpet laminectomy for lumbar degenerative spinal stenosis.

The clinical and radiologic results of trumpet laminectomy, an improved method of extensive laminectomy preserving the facet joints (n = 35), and extensive laminectomy (n = 15) were compared in patients with degenerative lumbar spinal stenosis. The results were evaluated using a rating system and serial radiographs and a follow-up of 2 to 10 1/2 years (mean, 5.2 years). The overall results corroborate the advantage of the trumpet laminectomy, demonstrating a lower incidence and lower grade of postoperative lumbar scoliosis as well as less symptom recurrence in the trumpet laminectomy group than in the extensive laminectomy group. Risk factors for postoperative spinal instability and scoliosis appear to be facet joint destruction and elderly females with a high level of physical activity.