Object : Unilateral partial hemilaminectomy with bilateral ligamentectomy (UPBILIT) is one of the less invasive procedures for treating lumbar spinal stenosis. Optionally, this decompression technique can also be combined with inter-spinous process fixation (+F) for those patients with minimum instability. In this study, the surgical results of single-level UPBILIT were retrospectively evaluated.
Methods : We conducted an analysis of data obtained in a consecutive series of 60 patients treated with single-level UPBILIT or UPBILIT+F over a 4-year period (April 2003-March 2007). Clinical outcome was measured using the Japan Orthopedic Association (JOA) score and JOA recovery rates. Prognostic factor and complicated cases were also evaluated.
Results : Forty patients had undergone UPBILIT and twenty patients with spinal instability had undergone UPBILIT+F. On an average of 24.2 months postoperatively, 54 of 60 patients (90%) experienced clinical benefit. The JOA score significantly improved from 14.6 to 21.0 (p<0.0005) with an average JOA recovery rate of 44.9%. Longer duration of disease correlated with the fair outcome group.Two patients (3.3%) experienced dural tear intraoperatively, and postoperative complications occurred in 4 patients (6.7%).
Conclusions : The favorable recovery rate and the low incidence of complication indicated that UPBILIT can be a useful decompression surgery for lumbar spinal stenosis. In addition, the procedure, by using inter-spinous process fixation, can also manage those patients with minimum spinal instability.