Degenerative Spondylolisthesis, Fusion, Lumbar Spinal Stenosis
Conditions
Brief summary
This study aimed to compare clinical results of decompression alone using minimal invasive unilateral laminotomy for bilateral decompression versus classical decompression and instrumentation and fusion.
Detailed description
The term "lumbar spinal stenosis" (LSS) describes the anatomical narrowing of the spinal canal, which occurs in older people because of spinal ageing. Initial treatment is usually medical. Surgical management is recommended for patients with failed non-surgical trials. As claudication is always the main complain, lumbar canal decompression is the traditional surgical treatment. Although adding instrumentation and fusion is not uncommon and widely used. In the literature, the benefit of fusion, is treating instability that causes degenerative spondylolisthesis, improve back pain if present, and avoid slippage progression, which possibly will occur with generous decompression and disruption of the posterior column.
Interventions
PROCEDUREUnilateral laminotomy decompression
Patients underwent unilateral laminotomy decompression.
PROCEDUREDecompression and fusion
Patients underwent a posterior decompression, (either with or without preservation of midline bands) was followed by instrumentation using pedicle screws with rods and intervertebral fusion device.
Sponsors
Kafrelsheikh University
Study design
Observational model
OTHER
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age \> 50 years. * Both sexes. * Patients with symptoms of lumbar spinal stenosis (LSS) (neurogenic claudication) confirmed by magnetic resonance imaging (MRI), and a degenerative spondylolisthesis measuring at least 3 mm at the stenotic level on a plain X-ray.
Exclusion criteria
* Patients with excessive foraminal stenosis (a deformed nerve root in the intervertebral foramen). * Thoracolumbar scoliosis of greater than 20 degrees. * Patients with significant instability in plan radiography dynamic study. * Patients who had previous spine surgery at lumbar region.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Assessment of low back pain | 14 months after the procedure | Low back pain was assessed using the Oswestry Disability Index (ODI), 10-question self-report questionnaire to measure functional disability and quality of life. It yields a percentage score from 0% (no disability) to 100% (severe disability). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Degree of pain | 14 months after the procedure | Each patient was instructed about leg pain assessment with the numeric rating scale (NRS) score. NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). |
| Incidence of complications | 14 months after the procedure | Incidence of complications were recorded. |
Countries
Egypt
Outcome results
None listed