Abstract
Background: The treatment decision of patients with moderately severe cases of degenerative lumbar spinal canal stenosis (LSS) whether conservative or surgical is highly dependable on physician evaluation without clear standards. The purpose of this study is to evaluate the effectiveness of conservative treatment of patients complaining of moderately severe degenerative LSS in comparison with surgical intervention throughout one year follow up. The present study was conducted on 60 patients with LSS: 30 patients treated with rehabilitation program and 30 patients treated with decompression surgery. All patients were assessed for pain and physical function before treatment, 3 months, 6 months and 12 months after treatment. Results: Both groups showed significant improvement of Oswestry Disability Index (ODI), ODI walk, and Zurich Claudication Questionnaire (ZCQ) symptoms and function subscales at 3, 6 and 12 months after treatment compared to baseline. However, at 1 year, the most patients of the conservative group did not maintain improvement in ODI and ZCQ subscales scores. The beneficial effect of operative treatment sustained throughout the 1-year follow-up. No serious complications were encountered in conservative group but, there were two patients in surgical group had serious complications. Conclusion: The conservative treatment yielded statistical significant improvement among patients with moderately severe LSS for three, six and twelve months follow up compared to baseline. Nonetheless, at all follow-up end points, the surgical group outperformed the conservative group statistically.
Highlights
Degenerative Lumbar spinal stenosis (LSS) is an anatomical impairment characterized by narrowing of central lumbar spine and nerve root canals, resulting in compression of the vascular and neural structures within the canals, that may be a widespread and disabling musculoskeletal disease
Aim of the work: The purpose of this study is to evaluate the effectiveness of conservative treatment of patients complaining of moderately severe degenerative lumbar spinal canal stenosis (LSS) in comparison with surgical intervention throughout one year follow up
There were no significant differences between both groups regarding age, gender, duration of disease, occupation and medication for neurogenic claudication
Summary
Degenerative Lumbar spinal stenosis (LSS) is an anatomical impairment characterized by narrowing of central lumbar spine and nerve root canals, resulting in compression of the vascular and neural structures within the canals, that may be a widespread and disabling musculoskeletal disease [1] This degenerative process is started by disc dehydration and bulging, causing disc space narrowing, and overstressing on the facet joints. Aim of the work: The purpose of this study is to evaluate the effectiveness of conservative treatment of patients complaining of moderately severe degenerative LSS in comparison with surgical intervention throughout one year follow up. The treatment decision of patients with moderately severe cases of degenerative lumbar spinal canal stenosis (LSS) whether conservative or surgical is highly dependable on physician evaluation without clear standards. The purpose of this study is to evaluate the Keywords effectiveness of conservative treatment of patients complaining of moderately severe degenerative LSS in comparison with surgical intervention throughout one year follow up. The present study was conducted on 60 patients with LSS: 30 patients treated with rehabilitation program and 30
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