| The Inducing Factors in Postoperative Lumbar Spinal Instability |
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Hee Il Kang, Do Hyun Kim, Tae Wan Kim, Joo Chul Yang, Kwan Ho Park |
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Department of Neurosurgery, Veterans Healthcare Service Medical Center, Seoul, Korea |
| 수술 후 발생하는 요추부 척추불안정증의 유발인자 |
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강희일, 김도현, 김태완, 양주철, 박관호 |
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| Abstract |
Objective
The purpose of this study was to analyze the different factors that contribute to spinal instability after decompressive lumbar surgery.
Methods
From January 2007 to December 2012, we selected 38 patients with a follow-up period of at least 3 years who underwent single-level subtotal laminectomy or bilateral partial laminotomy without spinal fusion. We measured slippage and segmental angulation for deciding the occurrence of spinal instability. We divided the patients into two groups by presence of postoperative instability. We analyzed the contributing factors including age, history of smoking, body mass index, presence of disc space narrowing, facet tropism, paravertebral muscle atrophy, and the operative method.
Results
The patients who had preoperative paravertebral muscle atrophy and taken subtotal laminectomy were frequently occurred postoperative spinal instability(p=0.050, and 0.049, respectively). All the patients who occurred slippage more than 3mm had paravertebral muscle atrophy.
Conclusion
Presence of preoperative paravertebral muscle atrophy and subtotal laminectomy may be contributing factors for spinal instability after decompression surgery, when compared to bilateral laminotomy group. A close follow-up may be needed for these patients. |
| Key Words:
Spinal stenosis, Atrophy, Laminectomy, Instability |
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