Best Abstract in Spinal Neurosurgery: Minimally invasive solutions of complicated degenerative compressive lumbar spinal lesions
EANS Academy. Aydin Y. 09/27/19; 281719
Prof. Dr. Yunus Aydin
Prof. Dr. Yunus Aydin

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Unilateral approaches allowed;
-sufficient and safe decompression of the neural structures,
-adequate preservation of vertebral stability (reducing the need for stabilization)
-resulted in a highly significant reduction of symptoms and disability,
-improved health-related quality of life,
-decrease the length of hospital stay and thereby the treatment costs.
Background: This present study was undertaken for analysis of 1093 patients with 3025
levels of degenerative lumbar spinal stenosis with or without degenerative
spondylolisthesis, one/two level disc herniation, and/or far-lateral-disc-herniation who
underwent bilateral decompression via a unilateral approach between 2000 and 2017. We
have conducted a study to compare the initial chief complaint, neurological status and
outcome of patients.
Methods: 168(15.3%) of 1093 patients underwent operation for lumbar stenosis
associated with degenerative spondylolisthesis. Decompression was performed at more
than 3 levels in 336(30.7%) patients. 261(23.8%) of 1093 patients underwent concomitant
discectomies at the index level. All patients were followed-up regularly at intervals of
1,6,12 months, and were followed up annually thereafter. All patients underwent MRimaging studies one year after surgery. Routine radiological investigations including
neutral, flexion/extension lateral radiographs at these time intervals were taken routinely.
Spinal canal size and (neutral and dynamic) slip percentages were measured both preand postoperatively. For clinical evaluations, Oswestry Disability Index (ODI), and Short
Form-36 (SF-36) were used.
Results: Neutral and dynamic slip percentages did not significantly change after surgery
(p=0.67 and p=0.61, respectively). The spinal canal was increased to 2,1-3.6-fold (mean
2.7 ± SD 0.3-fold) the preoperative size. The ODI scores decreased significantly in both
the early and late follow-up evaluations, and good or excellent results were obtained in
934 cases (85.4%). The SF-36 scores demonstrated significant improvement in the late
follow-up results (p< 0.001). Three patients (0.2%) required secondary fusion during the
follow-up period.
Conclusions: Postoperative clinical improvement and radiological findings clearly
demonstrated that the unilateral approach for treating complicated degenerative lumbar
spinal lesions is a safe, effective, and real minimally invasive method in terms of reducing
the need for stabilization.
Keywords: minimally invasive solutions, bilateral decompression via a unilateral
approach, degenerative spondylolisthesis, far lateral disc herniation; complicated
degenerative lumbar spinal lesions
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