Comparison of surgical outcomes in laminectomy versus laminotomy for the management of lumbar spinal stenosis

Introduction: Incidence of Lumbar Spinal Stenosis is increasing exponentially due to changing societal structure. There has been a great advancement in the minimally invasive spinal surgery in the recent years. Minimally decompressive procedures have been proposed for the treatment of spinal stenosis. The objective of the study was to compare the surgical outcome of laminectomy versus Laminotomy for the surgical management of Lumbar Spinal Stenosis. Methods: This cross sectional study was conducted at the Department of Neurosurgery Bolan Medical Complex Hospital Quetta and Sandeman Provincial Hospital Quetta, Pakistan from February, 2017 to August, 2018. Patients with >40 years of age of either gender presented with Oswestry disability percentage score of more than 40 pre-operatively and diagnosed as lumbar spinal stenosis with duration of symptoms more than 6 weeks were included. Group A (Laminotomy) patients underwent minimally invasive decompressive procedure. In group B patients, traditional laminectomy was performed. Both groups (A and B) were reassessed after treatment at 12 week follow up by Oswestry disability index (ODI). Outcome of surgery was labelled as good, fair and poor. Results: Mean age of the patients was 58.16 ±7.97 years. Mean duration of disease was 7.85 ±0.99 weeks. Male preponderance was found to be higher 117 (68.80%) as compared to females 53 (31.20%). Good outcome was found to be higher 76 (89.4%) in patients with Laminotomy as compared to the patients with laminectomy 53 (62.4%) (p-value 0.001). Conclusion: Surgical outcome of Laminotomy was found to be better than laminectomy in surgical management of lumbar spinal stenosis.