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THE INTERSPINOUS LIGAMENT SHOULD BE REMOVED FOR DECOMPRESSION WITH A CASE OF LUMBAR SPINAL CANAL STENOSIS.: GP138.

Yuzawa, Yohei M.D., Ph.D.

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Spine Journal Meeting Abstracts: October 2010 - Volume - Issue - p 280
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INTRODUCTION: The operative procedure especially for older people suffering from lumbar canal stenosis (LCS) should be simple, less invasive and quick. For that reason we remove the interspinous ligament and decompression is done using the space where the interspinous ligament had existed. The purpose of the study is to determine the efficacy of this procedure retrospectively and to confirm that the interspinous ligament could be removed for the decompression surgery.

METHODS: Seventy patients were treated and 63 patients were followed up for more than 4 years. Operative time, blood loss, complications of surgery and further surgery were checked out. During the follow‐up period, JAPANESE ORTHOPAEDIC Association score and lumbar spine X‐ray were evaluated.

RESULTS: The average operative time was 51 minutes, average operative time per one level was 32 minutes, and the average blood loss was 57 ml. The recovery rate was excellent in 26, good in 24, fair in 8 and poor in 5 patients. Four of 63 patients (6.3%) needed further surgery and among them only 2 cases (3.2%) needed reoperation because of the instability of the operative levels.

DISCUSSION: This procedure is simple, less invasive and quick since the space where the interspinous ligament had existed is used as a working space. Therefore it can be performed for patients with coexisting illness even if they are very old. Many studies have reported less aggressive surgical techniques which minimize the tissue disruption. However, these procedures are more complicated, more time consuming and involve more significant blood loss than the procedure currently we present. We removed the interspinous ligament, yet obvious lumbar spinal instability was not seen until more than 4 years after surgery. In conclusion, the interspinous ligament had better be removed for decompression with a case of LCS.

© 2010 Lippincott Williams & Wilkins, Inc.