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Archives of Orthopaedic and Trauma Surgery

, Volume 115, Issue 3–4, pp 211–215 | Cite as

Spinous process-plasty following lumbar laminectomy as a contributing factor to spine stability

  • D. Vranković
  • B. Splavski
  • I. Hećimović
  • K. Glavina
Clinical and Experimental Forum

Abstract

A 10-year retrospective study of 41 consecutive patients who underwent “spinous process-plasty” is presented. We carried out laminectomy of the lumbar spine in cases of spinal stenosis, dorsomedial herniated disc and recurrent disc herniation with firm scars (traumatic and tumour cases are not included). To forestall the development of laminectomy's negative effects on spine stability, we initiated the spinous processes' reconstruction. Two groups of patients who underwent laminectomy form the basis of this presentation, one group with “spinous process-plasty” (41 patients) and the other (11 patients) without it. On postoperative neutral and dynamic X-ray films we paid attention to horizontal displacements larger than 3 mm and to negative intervertebral angular displacement. Considering such criteria, only 3.8% of those with “spinous process-plasty” developed a radiographic instability in contrast to 25% of patients without “spinous process-plasty”. These results support the use of this technique, which provides postlaminectomy lumbar spine stability.

Keywords

Public Health Retrospective Study Lumbar Spine Contribute Factor Disc Herniation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Adams MA, Hutton WC (1980) The resistance to flexion of the lumbar intervertebral joint. Spine 5:245–253Google Scholar
  2. 2.
    Cusick JF, Pintar F, Mahadevappa M, Yoganandan N, Reinartz J (1990) Biomechanics of medial and total facetectomy. J Neurosurg 72:352–353Google Scholar
  3. 3.
    Garrido E, Connaughton PN (1990) Unilateral facetectomy for extreme lateral lumbar disc herniation: experience with 35 patients. J Neurosurg 72:325Google Scholar
  4. 4.
    Gunnar B, Anderson J (1993) Surgical aspects on lateral spinal stenosis. Acta Orthop Scand Suppl 251:74–75Google Scholar
  5. 5.
    Gur KR, McAfee PC, Shih CM (1988) Biomechanical analysis of posterior instrumentation systems after decompressive laminectomy. An unstabile calf-spine model. J Bone Joint Surg [Am] 70:680–691Google Scholar
  6. 6.
    Herron LD, Trippi AC (1989) L4-5 degenerative spondylolisthesis. The results of treatment by decompressive laminectomy without fusion. Spine 14:534–538Google Scholar
  7. 7.
    Hukins DWZ, Kirby MC, Sikoryn TA, Aspden RM, Cox AJ (1990) Comparison of structure, mechanical properties, and functions of lumbar spinal ligaments. Spine 6:787–796Google Scholar
  8. 8.
    Iida Y; Kataoka O, Sho T, Sumi M, Hirose T, Bessho Y, Kobayashi D (1990) Postoperative lumbar spinal instability occurring or progressing secondary to laminectomy. Spine 11:1186–1189Google Scholar
  9. 9.
    Johnsson KE, Wilner S, Johnsson K (1986) Postoperative instability after decompression for lumbar spinal stenosis. Spine 2:107–110Google Scholar
  10. 10.
    Jönsson BO (1993) Vertebral slipping after decompression for spinal stenosis. Acta Orthop Scand Suppl 251:76–77Google Scholar
  11. 11.
    Kummer B (1987) Biomechanics of the thoracic and lumbar spine. In: Harris P (ed) Advances in neurotraumatology, Vol 2. Springer, Berlin Heidelberg New York, pp 17–25Google Scholar
  12. 12.
    Lee CK (1983) Lumbar spinal instability (olisthesis) after extensive posterior spinal decompression. Spine 4:429–433Google Scholar
  13. 13.
    Loew F, Caspar W (1978) Surgical approach to lumbar disc herniations. In: Krayenbühl (ed) Advances and technical standards in neurosurgery, Vol 5. Springer, Berlin Heidelberg New York, pp 153–174Google Scholar
  14. 14.
    Maroon JC, Schulhof LA, Kopitnik TA (1990) Diagnosis and microsurgical approach to far lateral disc herniation in the lumbar spine. J Neurosurg 72:350Google Scholar
  15. 15.
    Murata M, Morio Y, Kuranobu K (1994) Lumbar disc degeneration and segmental instability: a comparison of magnetic resonance images and plain radiographs of patients with low back pain. Arch Orthop Trauma Surg 113:297–301Google Scholar
  16. 16.
    Postacchini F (1989) Lumbar spinal stenosis. Springer, Berlin Heidelberg New York, pp 173–215Google Scholar
  17. 17.
    Robertson PA, Grobler LJ, Novotny JE, Katz JN (1993) Postoperative spondylolisthesis at L4-5. The role of facet joint morphology. Spine 18:1483–1490Google Scholar
  18. 18.
    Roth JA, Kaufman HH (1976) Hypertrophy of the ligamentum flavum. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, Vol 20. North-Holland, Amsterdam, pp 809–817Google Scholar
  19. 19.
    San Martino A, D'Andria FM, San Martino C (1983) The surgical treatment of nerve root compression caused by scoliosis of the lumbar spine. Spine 3:261–265Google Scholar
  20. 20.
    Sano S, Yokokura S, Nagata Y, Young SZ (1990) Unstable lumbar spine without hypermobility in postlaminectomy cases. Mechanism of symptoms and effect of spinal fusion with and without spinal instrumentation. Spine 11:1190–1197Google Scholar
  21. 21.
    Scbaik van JPJ, Verbiest H, Schaik van FDJ (1986) The lower lumbar spinous processes, Part I. Length, its relationship with other morphological characteristics of the bony neural arch. Neuro-Orthopedics 1:45–51Google Scholar
  22. 22.
    Shenkin HA, Hash CJ (1979) Spondylolisthesis after multiple bilateral laminectomies and facetectomies for lumbar spondylosis. Follow-up review. J Neurosurg 50:45–47Google Scholar
  23. 23.
    Stromquist B (1993) Postlaminectomy problems with reference to spinal fusion. Acta Orthop Scand Suppl 251:87–89Google Scholar
  24. 24.
    Tsuji H, Itch T, Sekido H, Yamada H, Katoh Y, Makiyama N, Yamagami T (1990) Expansive laminoplasty for lumbar spinal stenosis. Int Orthop 14:309–314Google Scholar
  25. 25.
    Tuite GF, Stern JD, Doran SE, Papadopoulos SM, McGillicuddy JE, Oyedijo DI, Grube SV, Lundquist C, Gilmer HS, Schork MA, Swanson SE, Hoff JT (1994) Outcome after laminectomy for lumbar spinal stenosis. Part II. Radiographic changes and clinical correlations. J Neurosurg 81:707–715Google Scholar
  26. 26.
    Vranković DJ, Milić S (1987) Reconstruction of the spinal process and ligaments after laminectomy of the lumbar spine. Eighth European Congress of Neurosurgery 87, Barcelona, Spain, pp 328Google Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • D. Vranković
    • 1
  • B. Splavski
    • 1
  • I. Hećimović
    • 1
  • K. Glavina
    • 2
  1. 1.Division of NeurosurgeryOsijek Clinical HospitalOsijekCroatia
  2. 2.Division of Radiology, Osijek Clinical Hospital, Osijek Branch of Zagreb School of MedicineUniversity of ZagrebOsijekCroatia

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