Semester Award Granted
Summer 2025
Submission Date
July 2025
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Thesis/Dissertation Advisor [Chair]
Chi Tay Tsai
Thesis/Dissertation Co-Chair
Frank D. Vrionis,
Abstract
Lumbar spinal stenosis (LSS), disc degeneration disease (DDD), and spondylolisthesis are among the most common conditions affecting the human lumbar spine. Various surgical methods are available to treat these disorders. Laminectomy and minimally invasive surgery (MIS) are among the most commonly used procedures for their management. LSS refers to a narrowing of the space within the spinal canal, which can occur at any level but is most common in the lumbar spine. Spondylolisthesis is defined as an anterior translation of upper vertebra relative to the lower one and frequently occurs at the L5-S1 level. Degenerative Disc Disease is a condition characterized by the gradual loss of hydration and elasticity in the intervertebral discs of the spine, leading to reduced disc height, disc bulging, and in some cases, herniation. The traditional bilateral pedicle screw system has been used for the treatment of various lumbar spine conditions including advanced degenerative disc disease. However, there is an ongoing need to develop more effective and less invasive techniques. Open laminectomy and minimally invasive laminectomy (MIL) procedures are the most common surgical gold standard techniques for treating LSS. The aim of this dissertation is to draw comparisons between open laminectomy and various MIL techniques. The MIL variation comprises microendoscopic decompression laminotomy, unilateral partial hemilaminectomy, and microendoscopic laminectomy. In this dissertation, the range of motion (ROM), von Mises stresses, and stability were compared. MIL involves less bone and ligament removal, resulting in shorter hospital stays and lower reoperation and complication rates than open laminectomy. It improves the quality of health-related living standards and reduces postoperative pain. Biomechanical studies suggest that laminectomy and facetectomy increase annulus stress and ROM, leading to segmental instability. Theoretically, MIL means less tissue injury, pain, and faster recovery in the short term, although the long-term results depend on the adequacy of the decompression procedure and tend to be independent of MIL or open laminectomy. While studying the minimally invasive surgery, transdiscal screw system was compared with traditional bilateral screw system for low/high-grade spondylolisthesis and degenerative disc degeneration. Generally, transdiscal screw system exhibited biomechanical superiority over traditional bilateral pedicle screw system.
Recommended Citation
Dhar, Utpal K., "LAMINECTOMY AND MINIMALLY INVASIVE SURGERY FOR HUMAN LUMBAR SPINE" (2025). Electronic Theses and Dissertations. 105.
https://digitalcommons.fau.edu/etd_general/105