{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,30]],"date-time":"2024-08-30T15:47:57Z","timestamp":1725032877251},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:p>In the conventional posterior approach to the lumbar spine, the lamina is exposed by stripping the paravertebral muscles from the spinous process, and the resulting paravertebral muscle damage can produce muscle atrophy and decreased muscle strength. The author developed a novel surgical approach to the lumbar spine in which the attachment of the paravertebral muscles to the spinous process is preserved. In the novel approach, the spinous process is split on the midline without stripping the attached muscles, and a hemilateral half of the spinous process is then resected at the base, exposing only the ipsilateral lamina. Before closing, the resected half is sutured and reattached to the remaining half of the spinous process. Thirty-eight patients with lumbar spinal canal stenosis (LSCS) undergoing unilateral partial laminectomy and bilateral decompression using this novel approach were analyzed. Postoperative changes in the multifidus muscle were evaluated by T2 signal intensity on MR images. MRI performed 1 year after the operation revealed no significant difference in the T2 signal intensity of the multifidus muscle between the approach and nonapproach sides. This result indicated that postoperative changes of the multifidus muscle on the approach side were slight. The clinical outcomes of unilateral partial laminectomy and bilateral decompression using this approach for LSCS were satisfactory. The novel approach can be a useful alternative to the conventional posterior lumbar approach.<\/jats:p>","DOI":"10.3171\/2015.5.spine141074","type":"journal-article","created":{"date-parts":[[2015,11,6]],"date-time":"2015-11-06T15:07:58Z","timestamp":1446822478000},"page":"694-699","source":"Crossref","is-referenced-by-count":10,"title":["A novel surgical approach to the lumbar spine involving hemilateral split-off of the spinous process to preserve the multifidus muscle: technical note"],"prefix":"10.3171","volume":"24","author":[{"given":"Kenichi","family":"Chatani","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-spine141074","series-title":"Clin Anat","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1002\/ca.1099","article-title":"Danger of damaging the medial branches of the posterior rami of spinal nerves during a dorsomedian approach to the spine","volume":"15","author":"Boelderl","year":"2002"},{"key":"b2-spine141074","series-title":"Clinical Anatomy of the Lumbar Spine","first-page":"86","author":"Bogduk","year":"1991"},{"key":"b3-spine141074","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3171\/spi.2007.6.3.229","article-title":"Split-spinous process laminotomy and discectomy for degenerative lumbar spinal stenosis: a preliminary report","volume":"6","author":"Cho","year":"2007"},{"key":"b4-spine141074","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1097\/BSD.0b013e3182014aa1","article-title":"Multilevel lumbar spinal stenosis decompression: midterm outcome using a modified hinge osteotomy technique","volume":"24","author":"El-Abed","year":"2011"},{"key":"b5-spine141074","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1007\/s00586-009-1191-6","article-title":"Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach","volume":"19","author":"Fan","year":"2010"},{"key":"b6-spine141074","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"941","DOI":"10.1097\/00007632-200004150-00008","article-title":"Magnetic resonance imaging and histologic evidence of postoperative back muscle injury in rats","volume":"25","author":"Gejo","year":"2000"},{"key":"b7-spine141074","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1097\/00007632-199905150-00017","article-title":"Serial changes in trunk muscle performance after posterior lumbar surgery","volume":"24","author":"Gejo","year":"1999"},{"key":"b8-spine141074","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E276","DOI":"10.1097\/BRS.0b013e318195d943","article-title":"Muscle-preserving interlaminar decompression for the lumbar spine: a minimally invasive new procedure for lumbar spinal canal stenosis","volume":"34","author":"Hatta","year":"2009"},{"key":"b9-spine141074","series-title":"J Jpn Orthop Assoc","first-page":"393","article-title":"Assessment of treatment for low back pain","volume":"60","author":"Inoue","year":"1986"},{"key":"b10-spine141074","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2590","DOI":"10.1097\/00007632-199411001-00017","article-title":"Back muscle injury after posterior lumbar spine surgery. Part 1: Histologic and histochemical analyses in rats","volume":"19","author":"Kawaguchi","year":"1994"},{"key":"b11-spine141074","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2598","DOI":"10.1097\/00007632-199411001-00018","article-title":"Back muscle injury after posterior lumbar spine surgery. Part 2: Histologic and histochemical analyses in humans","volume":"19","author":"Kawaguchi","year":"1994"},{"key":"b12-spine141074","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1148\/radiol.2293020904","article-title":"MR imaging in the diagnosis of denervated and reinnervated skeletal muscles: experimental study in rats","volume":"229","author":"Kikuchi","year":"2003"},{"key":"b13-spine141074","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1016\/j.surneu.2007.04.021","article-title":"Comparison of the effect of 3 different approaches to the lumbar spinal canal on postoperative paraspinal muscle damage","volume":"69","author":"Kim","year":"2008"},{"key":"b14-spine141074","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1097\/BRS.0b013e318162458f","article-title":"Quantitative analysis of back muscle degeneration in the patients with the degenerative lumbar flat back using a digital image analysis: comparison with the normal controls","volume":"33","author":"Lee","year":"2008"},{"key":"b15-spine141074","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"359","DOI":"10.3171\/spi.2006.4.5.359","article-title":"Chimney sublaminar decompression for degenerative lumbar spinal stenosis","volume":"4","author":"Lin","year":"2006"},{"key":"b16-spine141074","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"570","DOI":"10.3171\/2009.11.SPINE09174","article-title":"Impact of surgical approaches on the lumbar multifldus muscle: an experimental study using sheep as models","volume":"12","author":"Liu","year":"2010"},{"key":"b17-spine141074","series-title":"Clin Biomech (Bristol, Avon)","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1016\/0268-0033(86)90146-4","article-title":"The morphology of the human lumbar multifldus","volume":"1","author":"Macintosh","year":"1986"},{"key":"b18-spine141074","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1097\/00007632-198901000-00006","article-title":"Comparison of CT scan muscle measurements and isokinetic trunk strength in postoperative patients","volume":"14","author":"Mayer","year":"1989"},{"key":"b19-spine141074","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"2105","DOI":"10.1007\/s00586-013-2806-5","article-title":"Tubular surgery with the assistance of endoscopic surgery via midline approach for lumbar spinal canal stenosis: a technical note","volume":"22","author":"Mikami","year":"2013"},{"key":"b20-spine141074","series-title":"J Bone Joint Surg Br","first-page":"550","article-title":"Microdecompression for lumbar spinal stenosis: the early outcome using a modified surgical technique","volume":"92","author":"Orpen","year":"2010"},{"issue":"2 Suppl","key":"b21-spine141074","series-title":"J Neurosurg","first-page":"213","article-title":"Bilateral decompression of lumbar spinal stenosis involving a unilateral approach with microscope and tubular retractor system","volume":"97","author":"Palmer","year":"2002"},{"key":"b22-spine141074","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1097\/00007632-199306000-00004","article-title":"Magnetic resonance imaging of the discs and trunk muscles in patients with chronic low back pain and healthy control subjects","volume":"18","author":"Parkkola","year":"1993"},{"key":"b23-spine141074","series-title":"Invest Radiol","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1097\/00004424-198805000-00007","article-title":"Magnetic resonance imaging of skeletal muscle. Prolongation of T1 and T2 subsequent to denervation","volume":"23","author":"Polak","year":"1988"},{"key":"b24-spine141074","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1227\/00006123-199508000-00025","article-title":"Central lumbar stenosis caused by ligamentum flavum: unilateral laminotomy for bilateral ligamentectomy: preliminary report of two cases","volume":"37","author":"Poletti","year":"1995"},{"issue":"1 Suppl","key":"b25-spine141074","series-title":"J Neurosurg","first-page":"122","article-title":"A new technique for exposure of the cervical spine laminae. Technical note","volume":"96","author":"Shiraishi","year":"2002"},{"key":"b26-spine141074","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1097\/00007632-199304000-00009","article-title":"Local denervation atrophy of paraspinal muscles in postoperative failed back syndrome","volume":"18","author":"Sihvonen","year":"1993"},{"key":"b27-spine141074","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1923","DOI":"10.1097\/BRS.0b013e3181a9d28e","article-title":"Mini-open versus conventional open posterior lumbar interbody fusion for the treatment of lumbar degenerative spondylolisthesis: comparison of paraspinal muscle damage and slip reduction","volume":"34","author":"Tsutsumimoto","year":"2009"},{"key":"b28-spine141074","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"405","DOI":"10.3171\/spi.2005.3.5.0405","article-title":"Lumbar spinous process-splitting laminectomy for lumbar canal stenosis. Technical note","volume":"3","author":"Watanabe","year":"2005"},{"key":"b29-spine141074","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1097\/00007632-199901010-00015","article-title":"Spinous process osteotomies to facilitate lumbar decompressive surgery","volume":"24","author":"Weiner","year":"1999"},{"key":"b30-spine141074","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2268","DOI":"10.1097\/00007632-199911010-00016","article-title":"Microdecompression for lumbar spinal canal stenosis","volume":"24","author":"Weiner","year":"1999"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/24\/5\/article-p694.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/24\/5\/article-p694.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/24\/5\/article-p694.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T21:57:58Z","timestamp":1681595878000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/24\/5\/article-p694.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,5]]},"references-count":30,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2015.5.spine141074","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2016,5]]}}}