Outcome of Decompression Alone Vs Decompression Plus Transpedicular Screw Fixation in Degenerative Lumbar Spine Stenosis

Abstract

Background: Degenerative lumbar spinal stenosis (DLSS) is a condition where degenerative and arthritic state of the disc and facet joints respectively results in the displacement of the vertebra resulting in lower back pain in association with radiculopathy. In patients with degenerative lumbar spine, the rate of fixation has increased. Aim: To identify the difference in outcome of decompression alone versus decompression with spinal fixation in DLSS. Place and duration of study: Department of Orthopaedic & Spine Surgery, Ghurki Trust Teaching Hospital, Lahore from 1st January 2017 to 31st December 2019. Methodology: All the discharged patients with primary diagnosis of DLSS were identified. Two subgroups were studied i.e. Decompression only and Decompression with TranspedicularScrew Fixation .Primary outcome among patients was assessed using Swiss Spinal Stenosis Score (SSS). All the data were entered and analyzed using SPSS software and p-value≤0.05 considered to be significant. Results: Total number of patients included in study was 87.out of the total,34(39%) patients had underwent decompression alone, whereas in 53(60.9%) patients decompression with transpedicular fixation were done. Significant difference was not observed among cases with respect to mean score on SSS based on two different types of surgical interventions. In decompression with fixation group, the average length of stay of patients in hospital was 6.4 days as compared to decompression only group as 4.4 days. Conclusion: Both surgical procedures decompression plus transpedicular fixation and decompression alone produce similar outcome at 2 years follow-up. Keywords: Decompression, Swiss Spinal Stenosis Score, Degenerative spine, Transpedicular screw fixation