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Comparison of Wiltse and classical methods in surgery of lumbar spinal stenosis and spondylolisthesis
Affiliations- Department of Neurosurgery, Konukoglu Hospital, Sanko University, Gaziantep, Türkiye
- Department of Neurosurgery, Sakarya University Training and Research Hospital, Sakarya, Türkiye
- Department of Neurosurgery, Deva Hospital, Gaziantep, Türkiye
- Department of Radiology, Konukoglu Hospital, Sanko University, Gaziantep, Türkiye
- Department of Neurosurgery, Koç University, İstanbul, Türkiye
- Department of Neurosurgery, Neuro Spine Academy, Istanbul, Türkiye
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Abstract
Minimally invasive approaches to posterior lumbar surgery are available today that can enhance patient comfort by greatly reducing tissue damage and offer better clinical results. However, such methods have not yet gained widespread popularity despite their significant advantages. This study compares the Wiltse method and the classical method of lumbar surgery based a cohort, clinical study of 57 patients. The patients all had degenerative lumbar spinal stenosis and/or spondylolisthesis and had developed multifidus muscular atrophy.
Materials and methodsWe enrolled 57 patients admitted to our clinic between April 2012 and September 2013 with a diagnosis of degenerative lumbar spinal stenosis and/or spondylolisthesis. These were treated with the classic posterior approach (n=26) or the Wiltse method (n=31).
FindingsIn the classical method group, the ratio of female to male patients was 20/6 and the mean age was 58.19±10.17 years. A comparison of preoperative and postoperative multifidus muscle cross-sectional measurements (average of right and left) revealed a 36.09% atrophy level in the classical method group and a 26.34% atrophy level in the Wiltse group (p<0.01). However, atrophy development was 18.82% higher in the classical method group (p<0.05) relative to the Wiltse group.
ConclusionThe Wiltse method is less invasive and causes less tissue damage. It reduces the change of hemorrhage and multifidus muscles and offers a shorter duration of hospitalization with less pain.
Abstract
Minimally invasive approaches to posterior lumbar surgery are available today that can enhance patient comfort by greatly reducing tissue damage and offer better clinical results. However, such methods have not yet gained widespread popularity despite their significant advantages. This study compares the Wiltse method and the classical method of lumbar surgery based a cohort, clinical study of 57 patients. The patients all had degenerative lumbar spinal stenosis and/or spondylolisthesis and had developed multifidus muscular atrophy.
Materials and methodsWe enrolled 57 patients admitted to our clinic between April 2012 and September 2013 with a diagnosis of degenerative lumbar spinal stenosis and/or spondylolisthesis. These were treated with the classic posterior approach (n=26) or the Wiltse method (n=31).
FindingsIn the classical method group, the ratio of female to male patients was 20/6 and the mean age was 58.19±10.17 years. A comparison of preoperative and postoperative multifidus muscle cross-sectional measurements (average of right and left) revealed a 36.09% atrophy level in the classical method group and a 26.34% atrophy level in the Wiltse group (p<0.01). However, atrophy development was 18.82% higher in the classical method group (p<0.05) relative to the Wiltse group.
ConclusionThe Wiltse method is less invasive and causes less tissue damage. It reduces the change of hemorrhage and multifidus muscles and offers a shorter duration of hospitalization with less pain.
Keywords
Wiltse, Laminectomy, Multifidus, Spinal stenosis, Spondylolisthesis
About this articleTitle
Comparison of Wiltse and classical methods in surgery of lumbar spinal stenosis and spondylolisthesis
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
251-257
Page views
411
Article views/downloads
630
DOI
10.1016/j.pjnns.2015.06.005
Bibliographic record
Neurol Neurochir Pol 2015;49(4):251-257.
Keywords
Wiltse
Laminectomy
Multifidus
Spinal stenosis
Spondylolisthesis
Authors
Murat Ulutaş
Can Yaldız
Mehmet Seçer
Mehmet Ali İkidağ
Mehmet Ali Cüce
Onur Yaman
Sedat Dalbayrak
