Investigation of Poor Cases after Operation for the Lumbar Spinal Stenosis

Abstract

We have a series of 110 patients with lumbar spinal stenosis who were treated by surgical procedure from September 1971 to March 1976.In these series 4 cases revealed poor results. Poor cases and their causes are suggested as follows;1. A 42-year old woman with degenerative stenosis increased cauda equina lesion after operation with some recovery following wide laminectomy and facetectomy.This case seemed to be caused in further damage of cauda equina due to transdural nucleotomy through so-called key-hole laminotomy.2. A 62-year old woman with degenerative stenosis and scoliotic deformity developed a postoperative hemorrhage causing cauda equina paralysis owing to the unstable hypertension with only slight recovery following removal of the blood clot and extensive laminectomy.3. A 66-year old woman with L4 spondylolisthesis had saddle anaesthesia following decompressive laminectomy without spinal fusion with gradual recovery of saddle anaesthesia. In this case anterior approach seemed to have been better procedure.4. A 47-year old woman with post-laminectomy stenosis had twice recurrence during 3 years.This case seemed to be caused in inadequate decompressive laminectomy and facetectomy owing to the prominent heaping of facets and hyperplasia of neural arches.