Dr. Ammar Saeed Rashid
Kufa University College of Medicine, Najaf, Iraq
Dr. Salim Mardan Omer
Ministry of Higher Education and Scientific Research, Kirkuk University \ College of Medicine, Kirkuk, Iraq
Dr. Hashim Jawad Jaafar
Emirates Health Service, Neurosurgery Department, Um Al Quwain Hospital, Um Al Quwain, United Arab Emirates
Dr. Ali Qais Abdulkafi
Iraqi Ministry of Health, Kirkuk Health Department, Kirkuk Teaching Hospital, Kirkuk, Iraq
ABSTRACT
Background: Laminectomy is a common decompressive surgical technique for treating lumbar spinal stenosis. Despite its recognized benefits, the procedure can lead to iatrogenic lumbar spine instability, raising concerns about when to integrate concurrent fusion. Objective: This study aimed to evaluate the pathological outcomes and clinical implications of iatrogenic lumbar spine instability post-laminectomy. Patients and Methods: We conducted a cross-sectional study of 40 patients who developed lumbar spine instability after undergoing laminectomy. Data was collected from several hospitals in Iraq between April 16, 2021, and August 25, 2022. The study utilized SPSS and Excel for data analysis, focusing on the correlation between clinical outcomes and pathological changes observed post-surgery. Results and Discussion: The investigation revealed significant pathological findings related to the mechanics of lumbar spine instability, including evidence of incomplete radial posterior tears in a substantial number of patients, which accounted for the predominant symptom of back pain observed in 32.5% of cases. The study also noted that preoperative functional status and comorbidities significantly influenced patient outcomes, underscoring the importance of a tailored surgical approach. Conclusion: This study highlights the critical need for careful assessment of lumbar spine pathology before and after laminectomy to better predict and manage postoperative instability. Our findings advocate for more rigorous diagnostic protocols and potentially the integration of fusion procedures in patients at high risk of instability to optimize surgical outcomes.
Keywords: Laminectomy; lumbar spine instability; Oswestry Disability Index (ODI); and VAS back score.
