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Treatment of lumbar spinal stenosis by extensive unilateral decompression and contralateral autologous bone fusion: operative technique and results.
- Source :
-
Journal of neurosurgery [J Neurosurg] 1996 Feb; Vol. 84 (2), pp. 166-73. - Publication Year :
- 1996
-
Abstract
- A new surgical technique for the treatment of lumbar spinal stenosis features extensive unilateral decompression with undercutting of the spinous process and, to preserve stability, uses contralateral autologous bone fusion of the spinous processes, laminae, and facets. The operation was performed in 29 patients over a 19-month period ending in December of 1991. All individuals had been unresponsive to conservative treatment and presented with low-back pain in addition to signs and symptoms consistent with neurogenic claudication or radiculopathy. Nine had undergone previous lumbar decompressive surgery. The minimum and mean postoperative follow-up times were 2 and 2 1/2 years, respectively. The mean patient age was 64 years; only two patients were younger than 50 years of age. Of the patients with neurogenic claudication, 69% reported complete pain relief at follow-up review. Of those with radicular symptoms, 41% had complete relief and 23% had mild residual pain that was rated 3 or less on a pain-functionality scale of 0 to 10. For the entire sample, this surgery decreased pain from 9.2 to 3.3 (p < 0.0001) on the scale. Sixty-nine percent of patients were satisfied with surgery. Low-back pain was significantly relieved in 62% of all patients (p < 0.0001). Low-back pain relief correlated negatively with number of levels decompressed (p < 0.05). To assess fusion, follow-up flexion/extension radiographs were obtained, and no motion was detected at the surgically treated levels in any patient. The results suggest that this decompression procedure safely and successfully treats not only the radicular symptoms caused by lateral stenosis but also the neurogenic claudication symptoms associated with central stenosis. In addition, the procedure, by using contralateral autologous bone fusion along the laminae and spinous processes, can preserve stability without instrumentation.
- Subjects :
- Adult
Aged
Aged, 80 and over
Evaluation Studies as Topic
Female
Humans
Image Processing, Computer-Assisted
Laminectomy
Lumbosacral Region
Male
Medical Illustration
Middle Aged
Postoperative Complications
Reoperation
Spinal Stenosis diagnostic imaging
Tomography, X-Ray Computed
Treatment Outcome
Spinal Fusion
Spinal Stenosis surgery
Subjects
Details
- Language :
- English
- ISSN :
- 0022-3085
- Volume :
- 84
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 8592217
- Full Text :
- https://doi.org/10.3171/jns.1996.84.2.0166