Shiraz Ahmed Ghori, Atiq Ahmed Khan, Muhammad Imran, Junaid Ashraf, Anam Hareem.
Comparison of short term surgical outcome of laminectomy and laminoforaminotomy by postoperative walking distance, in patients with neurogenic claudication due to single level lumbar stenosis.
Pak J Surg Jan ;31(1):54-61.

Objective: To compare the short term surgical outcome by post-operative walking distance in patient with neurogenic claudication aft er laminoforaminotomy and laminectomy. Study Design: Randomized controlled trial Place and duration of study: Department of Neurosurgery, Dow University of Health Sciences at Civil Hospital, Karachi from 15th April 2011 to 19th June 2012. Methodology: Patients having neurogenic claudication, due to a single level lumbar spinal stenosis and meeting the inclusion criteria were randomly placed into either group A or group B. Patients in group A were surgically managed by laminectomy while those in group B underwent laminoforaminotomy. Short term surgical outcome of the two groups was evaluated at one month by comparing postoperative walking ability and comparing this with their preoperative walking ability. Statistical analysis was performed by using SPSS 16.0. Results: Out of total 69 patients with neurogenic claudication, 33 were in laminectomy group whereas in 36 in laminoforaminotomy group. For both laminectomy & laminoforaminotomy groups, good walking tolerance (501 – 1000 m) was observed in 76% and 83% patients respectively, and excellent walking tolerance (> 1000 m) was observed in 9% and 11% patients respectively. Major improvement (good or excellent) was seen in 30 (94%) cases in Laminoforaminotomy group, as compared to 25 (85%) cases in Laminectomy group. However this improvement is statistically insignifi cant (p-value = 0.7, 95% CI =-9.11 to 21.36). Males had bett er outcomes in the Laminoforaminotomy group while females had bett er outcomes in the Laminectomy group. Conclusion: Adequate decompression of single level spinal stenosis with preservation of posterior elements can be performed by laminoforaminotomy and the outcome can be assessed satisfactorily by walking tolerance. Laminoforaminotomy can be the standard procedure for surgical treatment of degenerative spinal stenosis.

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