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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Adams MA, Hutton WC (1980) The resistance to flexion of the lumbar intervertebral joint. Spine 5:245–253
Cusick JF, Pintar F, Mahadevappa M, Yoganandan N, Reinartz J (1990) Biomechanics of medial and total facetectomy. J Neurosurg 72:352–353
Garrido E, Connaughton PN (1990) Unilateral facetectomy for extreme lateral lumbar disc herniation: experience with 35 patients. J Neurosurg 72:325
Gunnar B, Anderson J (1993) Surgical aspects on lateral spinal stenosis. Acta Orthop Scand Suppl 251:74–75
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] 70:680–691
Herron LD, Trippi AC (1989) L4-5 degenerative spondylolisthesis. The results of treatment by decompressive laminectomy without fusion. Spine 14:534–538
Hukins DWZ, Kirby MC, Sikoryn TA, Aspden RM, Cox AJ (1990) Comparison of structure, mechanical properties, and functions of lumbar spinal ligaments. Spine 6:787–796
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 11:1186–1189
Johnsson KE, Wilner S, Johnsson K (1986) Postoperative instability after decompression for lumbar spinal stenosis. Spine 2:107–110
Jönsson BO (1993) Vertebral slipping after decompression for spinal stenosis. Acta Orthop Scand Suppl 251:76–77
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 17–25
Lee CK (1983) Lumbar spinal instability (olisthesis) after extensive posterior spinal decompression. Spine 4:429–433
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 153–174
Maroon JC, Schulhof LA, Kopitnik TA (1990) Diagnosis and microsurgical approach to far lateral disc herniation in the lumbar spine. J Neurosurg 72:350
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 113:297–301
Postacchini F (1989) Lumbar spinal stenosis. Springer, Berlin Heidelberg New York, pp 173–215
Robertson PA, Grobler LJ, Novotny JE, Katz JN (1993) Postoperative spondylolisthesis at L4-5. The role of facet joint morphology. Spine 18:1483–1490
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 809–817
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 3:261–265
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 11:1190–1197
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 1:45–51
Shenkin HA, Hash CJ (1979) Spondylolisthesis after multiple bilateral laminectomies and facetectomies for lumbar spondylosis. Follow-up review. J Neurosurg 50:45–47
Stromquist B (1993) Postlaminectomy problems with reference to spinal fusion. Acta Orthop Scand Suppl 251:87–89
Tsuji H, Itch T, Sekido H, Yamada H, Katoh Y, Makiyama N, Yamagami T (1990) Expansive laminoplasty for lumbar spinal stenosis. Int Orthop 14:309–314
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 81:707–715
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 328
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Vranković, D., Splavski, B., Hećimović, I. et al. Spinous process-plasty following lumbar laminectomy as a contributing factor to spine stability. Arch Orthop Trauma Surg 115, 211–215 (1996). https://doi.org/10.1007/BF00434556
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00434556