Fenestration versus Conventional Laminectomy with and without Transpedicular Fixation for Secondary Lumbar Canal Stenosis

AlBakry, Amr; Ismaeil, Adel Saad; Amer, Ahmed Abdallah Mohamed; Ezzat, Ahmed Mohamed

doi:10.21608/zumj.2025.375836.3909

Fenestration versus Conventional Laminectomy with and without Transpedicular Fixation for Secondary Lumbar Canal Stenosis

Document Type : Original Article

Authors

¹ Assistant Professor of Neurosurgery, Faculty of Medicine, Zagazig University

² Professor of Neurosurgery, Faculty of Medicine, Zagazig University

³ MBBCH, Faculty of Medicine, Zagazig University

⁴ Lecturer of Neurosurgery, Faculty of Medicine, Zagazig University

10.21608/zumj.2025.375836.3909

Abstract

Background: One of the most prevalent disorders among the elderly is spinal stenosis. It is described as the spinal canal narrowing. The first line therapy for lumbar canal stenosis (LCS) should be conservative ideally using a multimodal strategy. The current study aims to compare the radiological and clinical outcome of bilateral fenestration canal decompression and conventional laminectomy with or without fixation in secondary LCS.

Methods: This clinical trial study was performed in Department of Neurosurgery, Faculty of Medicine, Zagazig University Hospitals. 21 cases in three groups each group includes 7 patients, (Group 1) Conventional Laminectomy without fixation, (Group 2) Conventional Laminectomy with fixation, and (Group 3) Bilateral fenestration. All patients were subjected to complete history taking, clinical examination, laboratory tests, and radiographical assessment.

Results: There was substantial variance between groups concerning VAS low back and after 2 weeks and 3 months (P<0.01), within groups, there was remarkable variation (P<0.01). Regarding complications, there was no significant variance between groups respecting neurological deficit, dural tear, wound infection and epidural hematoma (P>0.05). There was significant variance between the studied groups regarding satisfaction scoring (p=0.03).

Conclusion: Bilateral fenestration appears to be a highly effective and potentially superior technique for treating secondary lumbar canal stenosis, offering benefits in terms of operative parameters, clinical outcomes, and patient satisfaction.

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