Abstract

A four year results of posterior open laminectomy for spinal stenosis in a specialist hospital

Lumbar spinal stenosis (LSS) is a reduction in the volume of the central spinal cord, the lateral recesses and/or neuroforamina that decreases the space available for thecal sac and/or exiting nerve root(s). Both empiric and randomized evidence exist, providing superior efficacy of surgery compared to medical management for lumbar spinal stenosis. Traditionally, lumbar spinal stenosis is decompressed with open laminectomy that is removal of the spinous process, lamina and the posterior musculo-ligamentous complex (posterior tension band). However, it is also associated with potential postoperative complications, including spinal instability; this may result in the future need for spinal fusion. In Northern Ghana, there exist no scientific data on lumbar spinal stenosis, and its surgical management. The objective of this study was to report on 27 conservative patients with symptomatic lumbar spinal stenosis, from January, 2010 to December, 2013, who underwent posterior open laminectomy in Tania specialist Hospital, Tamale, Ghana. Most of the subjects were within the age group of 20 to 50 years. The study was a retrospective one involving 27 conservative patients with diagnostic image confirmed LSS cases, who had posterior open laminectomy done over a four year period. Data regarding patient’s age, sex, cause of injury, duration of complaint(s), nature of complaint(s), presence of associated disease and patient’s medication(s) among others, from January, 2010 to December, 2013 were recorded. The incidence of symptomatic lumbar spondylolithias is over the study period was 6.02% (289/4,800) of all orthopaedic cases within the study period. Twenty-seven cases(9.34%) out of the 289 patients who had spondylolithiasis and spinal canal stenosis with / without nerve root compression or patients with failed conservative therapy had posterior open decompression laminectomy done. Of the 27 patients who were operated 8 (29.63%) were females and 19 (70.37%) were males.160 females(55.36%) reported within the study period with symptomatic spondylolithiasis, and a male to female ratio of 1:1.2 was recorded. There were no postoperative complications. Only one (3.7%) patient developed haematoma. In conclusion, posterior open spinal decompression (laminectomy) is relevant for symptomatic lumbar spinal stenosis in developing countries, like Ghana, where minimal invasive spine surgery cannot be done.


Author(s): Kuubiere C. B., Abass A. and Majeed S. F

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