Outcomes of lumbar canal stenosis treated with posterior decompression and spinal instrumentation

2019 
Introduction: Lumbar spinal stenosis is a frequent indication for spinal surgery. The clinical symptoms may not be accurately reflected on radiological studies. Treatment is aimed at not only obtaining immediate pain relief but also in preventing its long?term disabling sequelae. The walking ability needs to be correlated with functional outcome measures in assessing patients with symptomatic lumbar canal stenosis (LCS). Aims and Objectives: To study and evaluate the outcome of surgery for degenerative LCS on a clinical, radiological, and functional basis, and to establish an association between various factors that may be influencing the development of LCS. Materials and Methods: A prospective study of 24 patients was carried out at the Department of Orthopaedics, Dhiraj General Hospital, Piparia, Vadodara, in whom the LCS was confirmed and measured on magnetic resonance imaging images by thecal sac cross?sectional area (CSA). The functional assessment pre-operative and post-operatively was calculated according to the Japanese Orthopaedic association score. Results: Overall, 83.33% patients (n=20) in our study showed improvement in all variables of the JOA scoring system postoperatively. 66.66% patients (n=16) showed excellent outcome, 25% (n=6) showed good outcome, and 8.33% (n=2) showed fair outcome. No patient had poor outcome. After surgery 95.83% patients (n=23) had normal gait with walking distance more than 500 m and no claudication symptoms. Conclusions: Operative treatment in patients of degenerative lumbar canal stenosis with decompression and spinal instrumentation yields excellent results as observed on the basis of JOA scoring system. Keywords: Spine, Stenosis, Decompression, Disc, Claudication.
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