A study of clinical outcomes of only decompression versus decompression with instrumented fusion for surgical management of lumbar canal stenosis in tertiary health care center in south Gujarat

Lumbar spinal stenosis is one of the most common conditions seen in elderly. It is a degenerative progressive disorder which leads to considerable disability. Patients not responding to conservative management requires surgical intervention. Different modalities for surgical interventions available. Decompression by laminectomy discectomy or micro lumbar discectomy or micro endoscopic discectomy can be done. Decompression with addition of instrumented fusion with help of pedicle screws and rods with or without TLIF/PLIF. Hence to compare the clinical outcomes of decompression and decompression with instrumented fusion this study is done. In most patients, conservative management is considered for relieving pain and functionally improving walking and standing time. The patients not improving with conservative management for at least 6 weeks and having clinically and radiologically lumbar canal stenosis requires surgical intervention. Apart from Minimal invasive surgery Decompression with or without fusion has been traditional definitive therapy offered. In this study we found that surgical treatment was influenced by presenting complaint of the patient. Patients with predominant back pain were more often operated with decompression with fusion whereas patients having radiculopathy or claudication were more often operated with decompression only. In this study clinical outcomes of decompression only and decompression with fusion were found similar. However, blood loss during surgery, duration of surgery and duration for return to work/occupation were more in decompression with fusion surgery which was found statistically significant.