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Academia Mexicana de Neurología, A.C.

2006, Number 1

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Rev Mex Neuroci 2006; 7 (1)

Lumbar spinal stenosis syndrome. Features, surgical treatment and results. Prospectively analyse of 62 cases

Ávila RJ, Aguilar LR, Ávila CR

Language: Spanish
References: 32
Page: 80-84
PDF size: 228.49 Kb.


ABSTRACT

Background: Lumbar spinal stenosis is a common condition in patients 60 years or older. Spinal decompression with or without fusion have been shown to be beneficial in the surgical treatment of symptomatic spinal stenosis. Purpose: The aim of this study was to evaluate the functional outcome of severe symptomatic lumbar spinal stenosis patients, after decompressive surgery without fusion. Study design: A prospective non randomized study on patients who underwent lumbar decompression for lumbar spinal stenosis. Patient sample: Sixty two consecutive patients who underwent decompressive surgery for lumbar spinal stenosis without fusion between 1997 and 2003 were evaluated. The cohort consisted of 38 female and 24 male with a mean age of 67.4 years (range 55-84 years). Follow-up from 1 to 6 years, average 3.8 years. Surgical technique: Under magnification wide surgical decompression was carried-out. Results: Sixty two patients were prospectively evaluated. All patients were evaluated postoperatively at one, three, six months and yearly. Levels affected L3-L4 (17), L4-L5 (59), L5-S1 (49). Spine and thecal sac diameters were 9 x 9.2 mm and 4.5 x 4.5 mm average respectively. We decompressed 125 levels. The average preoperative/postoperative JOA scores were: 11.66 ± 2.9/24.9 ± 1.6, χ2 10.41, p = 0.0013. Dural tears in two cases. Reoperations 4 (6.5%). Conclusions: Functional evaluation showed a significant improvement in symptomatology and neurological deficit. Non incapacitating low back pain remained in 25% of patients. Eighty five percent of the patients were satisfied with the results of surgery. Morbidity was low. We conclude on the basis of these results that decompression without fusion for lumbar spinal stenosis is a successful and safe procedure for elderly patients and should be considered as a treatment option for them.


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