Long Term Results of Decompressive Laminectomy in Treatment of Lumbar Spinal Canal Stenosis (A Thirty Years Retrospective Study)

Background: New minimal invasive procedure is trying to replace the old classic decompressive laminectomy. Result of the decompressive laminectomy should be well documented to compare these new procedures with it. Objective: To evaluate the long term results of wide decompressive laminectomy in treatment of lumbar spinal canal stenosis (LSCS). Patients and Methods: 384 cases having circumferential narrowing of their lumbar spinal canal with no evidence of sondylolisthesis or other bone pathology operated by open wide decompressive laminectomy through the period from 1976-2006, the results of surgery is evaluated first after one year then on a regular five years interval in a retrospective study to evaluate the results according to the JOA and POLO scales and to measure the recovery rate utilizing the Hirabayashi method. Results: Follow up after one year revealed marked improvement in most cases (74.3) according to the JOAscale, 73% were grade 5 according to the POLO scale and the recovery rate was excellent 74.2% on utilizing the Hirabayashi method. This improvement was maintained throughout the period of follow up . the last follow up conducted on 123 patients revealed persisten excellent recovery rate in 72.1 of them according to Hirabyashi method. Conclusion: In properly selected cases of LSCS open wide decompressive laminectomy has stood the test of time as a safe, simple, rapid procedure with much less incidence of complications and maintained long term patient improvement than other advocated minimally invasive surgical (MIS) techniques which still need evidence based evaluation of its results .