Microdecompression and uninstrumented single-level fusion for spinal canal stenosis with degenerative spondylolisthesis.

Microdecompression and uninstrumented single-level fusion for spinal canal stenosis with degenerative spondylolisthesis.

McCulloch J A

Spine

1998

1998-10

STUDY DESIGN: A retrospective review was completed on 21 patients who had a "least invasive" (one or two level) microdecompression and uninstrumented single-segment lumbar fusion for spinal canal stenosis with degenerative spondylolisthesis. OBJECTIVE: To determine whether a "least invasive" approach to lumbar spinal canal stenosis and degenerative spondylolisthesis would yield acceptable results. SUMMARY OF BACKGROUND DATA: The prevailing surgical technique for symptomatic spinal canal stenosis with degenerative spondylolisthesis is a wide midline decompression and instrumented fusion. METHODS: On an average of 38 months postoperatively, 21 patients were personally assessed on four scores: 1) their overall satisfaction with the outcome of surgery, 2) an analog back and leg pain scale, 3) a functional evaluation scale, and 4) Ferguson (upshot) anterior-posterior lumbosacral and lateral flexion-extension radiographs. RESULTS: The overall satisfactory outcome on all four scales was 16 (76%) of 21. Twenty of twenty-one patients had relief of their claudicant leg pain; the overall fusion rate was 18 (86%) of 21. Two of three patients with a pseudarthrosis had a successful outcome on the patient-oriented outcome (1, 2, and 3) scales (excluding the radiograph scale), and one was a failure. One patient with a solid fusion was a failure because of continuing back pain. One patient with a solid fusion was a failure because of continuing leg pain. The overall satisfactory outcome on the nonradiographic scales was 18 of 21, for an 86% patient satisfaction rate. CONCLUSIONS: In this retrospective study, a "least invasive" surgical approach to lumbar degenerative spondylolisthesis with spinal canal stenosis causing claudicant leg pain produced acceptable results.

Decompression; Dermatologic Surgical Procedures; Dissection; Follow-Up Studies; Hospital Costs; Humans; Length of Stay/economics; Lumbar Vertebrae/pathology; Magnetic Resonance Imaging; Retrospective Studies; Spinal Cord Compression/diagnosis/pathology/*surgery; Spinal Fusion/economics/*methods; Spinal Stenosis/diagnosis/pathology/*surgery; Spondylolisthesis/diagnosis/pathology/*surgery; Surgical/economics/*methods; Treatment Outcome

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2243–2252

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