Surgical treatment of narrow degenerative lumbar canal. Case series
DOI:
https://doi.org/10.1016/j.rccot.2016.02.011Keywords:
degenerative lumbar spinal stenosis, treatment, surgery, functional limitation, outcomesAbstract
Background: The primary objective of the surgical treatment is to relieve patient’s symptoms, reduce the disability, correct deformities, stabilize the column, diminish the fixed segments, protect neurological organs and decrease rehabilitation time in patients where conservative treatment had failed. The aim of the study is to compare the percentage of functional limitation and pain intensity in the presurgical and postsurgical period in patients with lumbar spinal stenosis with surgical treatment with decompressive laminectomy, transpedicular instrumentation and arthrodesis.
Methods: Descriptive, comparative longitudinal study of 30 records of patients with clinical and imagenological diagnosis, where the Oswestry Disability Index and Visual Analogue Scale were applied in the pre and three-months postsurgical treatment.
Results: The most of the patients had canal defects in two or more levels (69.9%), mainly between L4-L5. Needed instrumentation of two or more levels (79.9%). There were intrasurgical complications in three of the patients (13.3%), all were dural tears; it was only one case of fistula as postsurgical complication (3,3%). About postsurgical results, it was observed a median difference of Visual Analog Scale between presurgical and postsurgical of 5.1 points, and the difference in the median and standard deviation in the pre and postsurgical Oswestry Disability Index of 33.3%. All ofthe patients submitted to surgicaltreatment by this technique had relevant postsurgical clinical relevance during a postsurgical following of 18,6 ± 11,8 months.
Discussion: The decompressive laminectomy technique, transpedicular instrumentation and arthrodesis was effective to accomplish a clinical relevant benefit in patients with degenerative lumbar spinal stenosis.
Evidence level: IV.
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