Surgical outcome of multiple level laminotomies in patients with lumbar canal stenosis at multiple level: A prospective hospital based interventional study

Background: Lumbar canal stenosis (LCS) is a common degenerative spinal disorder characterized by neurogenic claudication, low back pain, radiculopathy, and functional disability. Multilevel laminotomy has emerged as a motion-preserving decompressive technique that aims to achieve adequate neural decompression while minimizing postoperative spinal instability. The purpose of this study was to evaluate the functional and clinical outcomes of multilevel laminotomies in patients with multilevel degenerative lumbar canal stenosis.

Methods: Twenty patients diagnosed with multilevel degenerative lumbar canal stenosis underwent decompressive multilevel laminotomies without fixation. Functional outcome and pain relief were assessed using the Self-Paced Walk Test (SPWT), Oswestry Disability Index (ODI), and Visual Analog Scale (VAS) for leg and back pain. Patients were followed up at 6 weeks, 6 months, and 9 months postoperatively.

Results: Mean SPWT improved drastically from 124.92±131.09 meters pre-operatively to 1482±127.28 meters post- operatively after 9 months. This drastic improvement in SPWT was statistically significant (p-value <0.001). The mean ODI score improved from 57.32 ± 11.99 preoperatively to 7.48 ± 6.07 at final follow-up (p < 0.001). Mean VAS leg pain improved from 7.44 ± 1.11 to 0.86 ± 1.43, while VAS back pain improved from 5.96 ± 1.86 to 1.10 ± 1.34 at 9 months postoperatively (p < 0.001). No significant postoperative spinal instability was observed on dynamic radiographs.

Conclusion: Multilevel laminotomy is a safe, effective, and motion-preserving surgical technique for the management of multilevel lumbar canal stenosis. It provides significant improvement in functional capacity, disability status, and pain relief while preserving spinal stability.