Outcomes of Microscopic-Assisted Decompression Surgery Without Instrumented Fixation in Patients With Spinal Canal Stenosis and First-Degree Degenerative Spondylolisthesis: A Prospective Case Series

Abstract

Objective: To describe the minimally invasive, microscopic-assisted over-the-top technique and report its clinical and radiological outcomes in cases of spinal canal stenosis and first-degree degenerative lumbar spondylolisthesis.Methods: Twenty-two patients with grade I degenerative spondylolisthesis and spinal canal stenosis who underwent microscopic decompression without fusion between April 2017 and December 2020 were included in the study. Results: The study population included 13 men and 9 women, with an average age of 66.7 years (range, 55–79 years) and a mean duration of symptoms of 14.8 ± 11.6 months. The mean follow-up was 49.3 months (range, 24–67 months). At the last follow-up, 13 patients were fully satisfied, 7 patients were partially satisfied, and 2 patients (9%) were not satisfied and required revision surgery with fusion. At the final follow-up, the mean leg pain numerical pain rating scale (NPRS), back pain NPRS, Oswestry Disability Index score, and Japanese Orthopaedic Association Back Pain Evaluation Questionnaire showed significant improvements in all patients, and no patients showed progression of the degree of spondylolisthesis.Conclusion: The minimally invasive, over-the-top technique using surgical microscopy is a viable option in cases with first-degree degenerative spondylolisthesis and predominantly stenosis symptoms.