Navigated minimally invasive unilateral laminotomy with crossover for intraoperative prediction of outcome in degenerative lumbar stenosis :Salvatore Massimiliano Cardali, Fabio Cacciola, Giovanni Raffa, Alfredo Conti, Maria Caffo, Antonino Germanò, Journal of Craniovertebral Junction and Spine

ORIGINAL ARTICLE
Year : 2018 | Volume : 9 | Issue : 2 | Page : 107--115

Navigated minimally invasive unilateral laminotomy with crossover for intraoperative prediction of outcome in degenerative lumbar stenosis

Salvatore Massimiliano Cardali¹, Fabio Cacciola¹, Giovanni Raffa², Alfredo Conti¹, Maria Caffo¹, Antonino Germanò¹
¹ Division of Neurosurgery, University of Messina, Messina, Italy
² Division of Neurosurgery; Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy

Correspondence Address:
Dr. Giovanni Raffa
Department of Clinical and Experimental Medicine and Division of Neurosurgery, University of Messina, AOU Policlinico �DQ�G. Martino�DQ�, Via Consolare Valeria 1, 98125 Messina
Italy

Background: Different surgical techniques have been described for treatment of degenerative lumbar stenosis (DLS). Only postoperative measures have been identified as predictors of efficacy of decompression. The objective of this study is to assess the role of navigated unilateral laminotomy with crossover to achieve and predict a satisfying decompression and outcome in DLS. Materials and Methods: We enrolled patients with DLS who underwent navigation-assisted unilateral laminotomy with crossover. The extent of decompression was evaluated during surgery using neuronavigation. The outcome was assessed through the Oswestry disability index (ODI) and visual analog scale (VAS) for leg pain. Outcome correlation with the extent of the intraoperative bone decompression was analyzed. Finally, the outcome, surgical time, and in-hospital length-of-stay were compared with a control group treated through standard unilateral laminotomy. Results: Twenty-five patients were treated using the navigated technique (Group A), 25 using the standard unilateral laminotomy (Group B). In Group A, a cut-off value ≥0.9 cm for bone decompression revealed to be an intraoperative predictor of good outcome, both regarding the ODI and VAS scores (P = 0.0005; P = 0.002). As compared with Group B, patients operated using the navigated technique showed similar operative times, in-hospital length-of-stay, ODI scores, but improved VAS scores for leg pain (P = 0.04). Conclusions: The intraoperative navigated evaluation of the bone decompression could predict the outcome allowing satisfactory results in unilateral laminotomy for DLS. The navigated technique also could lead to an improved decompression of lateral recesses resulting in better control of leg pain as compared to standard unilateral laminotomy.

How to cite this article:
Cardali SM, Cacciola F, Raffa G, Conti A, Caffo M, Germanò A. Navigated minimally invasive unilateral laminotomy with crossover for intraoperative prediction of outcome in degenerative lumbar stenosis.J Craniovert Jun Spine 2018;9:107-115

How to cite this URL:
Cardali SM, Cacciola F, Raffa G, Conti A, Caffo M, Germanò A. Navigated minimally invasive unilateral laminotomy with crossover for intraoperative prediction of outcome in degenerative lumbar stenosis. J Craniovert Jun Spine [serial online] 2018 [cited 2023 Jun 3 ];9:107-115
Available from: https://www.jcvjs.com/article.asp?issn=0974-8237;year=2018;volume=9;issue=2;spage=107;epage=115;aulast=Cardali;type=0