Optimizing Spinal Fusion in Degenerated Spinal Stenosis, proposing a hybrid scoring system for Bangladesh people in law Sack pain

Abstract

Background: Degeneration is a progressive phenomenon in lumbar spinal stenosis patients. The outcome of surgery predictors is sometimes biased. Fusion and stabilization in such cases are unnecessary in many situations. There is still a debate to decompress only versus fusion in low-grade listhesis. Fusion and stabilization in the aged lumbar spine should have clear indications. Objective: To assess whether the fusion is necessary in lumbar spinal stenosis in selected cases or not and to create a new scoring system among the patients of low backache in Bangladeshi people. Method: A total of 120 cases were observed retrospectively from 2012 to 2018 in Comfort Hospital, Dhaka, Bangladesh. And 40 more cases data will be collected in the upcoming study period of 6 months. To assess the study we will conduct a survey. In previous cases, the patients had undergone three types of surgeries (Laminectomy, Unilateral approach, and Fusion surgeries). ODI and Swiss score were used for assessment of functional outcome. A new scoring system has been made for patients who may be benefited from fusion or non- fusion surgeries. Results: In retrospective data, there were 80 male and 40 female patients. Maximum patients were between 41 to 50 years. 59.17% were heavy workers and 66.67% were smoker. Maximum patients (59.17%) had undergone unilateral surgical approaches and 18.33% undergone fusion surgeries. 98.33% patients had satisfactory outcome in our study. In our hybrid scale, the pain status showed, 52.50% had moderate pain, 22.50% had mild pain, 20% had severe pain and only 5% had very severe pain. Maximum participants having low back pain were below 30 years old and 65% lift weight more than 25 kg. The total pain score was significant in our correlation test. The Cronbach's Alpha (.784) was significant in Bangladeshi socio- demographic population. Conclusion: The outcome of such a study will help to know either fusion surgeries in selected cases are effective for lumbar spinal stenosis or not. Also, it will probably help to select patients for such a study and to improve surgical treatment methods. Bangladesh Med Res Counc Bull 2023; 49: 164-170