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Slide1
Effectiveness of posterior decompression techniques compared with conventional laminectomy for lumbar stenosis
Overdevest et al (2015)
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Slide2Objectives:
To compare the effectiveness of posterior decompression techniques that limit the extent of bony decompression or avoid removal of posterior midline structures of the lumbar spine versus conventional facet-preserving laminectomy for the treatment of patients with degenerative lumbar stenosis.Methods:Evidence current up to 9 June 2014
Participants: Adults with symptomatic degenerative lumbar stenosisInterventions: Posterior decompressive technique that avoids removal of posterior midline structures or a technique involving only partial resection of the vertebral arch with conventional facet-preservingOutcomes:Primary: Functional disability, patient recovery, leg painSecondary: length of hospital stay, complication incidence, length of surgical procedure and others
Effectiveness of posterior decompression techniques
Overdevest
et al (2015)
Overview of the study
Slide3Effectiveness of posterior decompression techniques
Overdevest et al (2015)
10 trials (773 participants)Results & ConclusionsIntervention
Evidence
Quality
of evidence
Posterior
decompression techniques
Laminectomy is as effective as unilateral
laminotomy
and self-spinous process laminotomy for improving disability, but less effective than bilateral laminotomyVery low - LowLaminectomy is as effective as unilateral laminotomy, but less effective than bilateral laminotomy for self-perceived recoveryLowBilateral laminotomy and split-spinous process laminotomy achieves more pain relief than laminectomyVery low
Adverse events: No significant difference was found regarding the incidence of perioperative complications, length of surgical procedure, and postoperative walking distanceAs the quality of the evidence is low to very low, further research is needed to determine whether other techniques are a safe and effective alternative to laminectomy