Comparison of

There are many cases with lumbar disk herniation in which asymptomatic lumbar canal stenosis will be diagnosed radiologically. In current study، we compared the outcomes of treating these patients with either laminectomy or laminotomy.

In this randomized clinical trial، there were 40 patients with lumbar disk herniation and asymptomatic lumbar canal stenosis assigned to 2 groups: laminectomy and fenestration. The severity of pain and disability were determined utilizing visual analogue scale (VAS) and Oswestry disability index (ODI) both before and after the surgery and the scores were compared in each group and between the two groups. The outcome of surgery was also compared using Japanese Orthopaedic Association (JOA) scoring system in a one year follow-up. The surgical time، blood loss and duration of hospital stay were also compared.

Significant postoperative decrease in severity of pain and ODI were found in both groups (p<. 001). However، the severity of pain، ODI score and outcomes based on JOA were the same between groups. The mean of surgical time and blood loss were significantly lower in laminotomy group (p<. 001)، but the mean of hospital stay was the same.

The short-term outcome of the two treatment methods is the same and favorable. However، because of the more invasive nature of laminectomy، which is associated with increased risk of instability، the authors suggest that in patients with lumbar intervertebral disk herniation and radiological lumbar canal stenosis، Laminotomy would be a preferred technique.