Abstract
Background and Objectives: In recent literature, the routine addition of arthrodesis to decompression for lumbar spinal stenosis (LSS) with concomitant stable low-grade degenerative spondylolisthesis remains controversial. The purpose of this study is to compare the clinical outcome, complication and re-operation rates following minimally invasive (MIS) tubular decompression without arthrodesis in patients suffering from LSS with or without concomitant stable low-grade degenerative spondylolisthesis. Materials and Methods: This study is a retrospective review of prospectively collected data. Ninety-six consecutive patients who underwent elective MIS lumbar decompression with a mean follow-up of 27.5 months were included in the study. The spondylolisthesis (S) group comprised 53 patients who suffered from LSS with stable degenerative spondylolisthesis, and the control (N) group included 43 patients suffering from LSS without spondylolisthesis. Outcome measures included complications and revision surgery rates. Pre- and post-operative visual analog scale (VAS) for both back and leg pain was analyzed, and the Oswestry Disability Index (ODI) was used to evaluate functional outcome. Results: The two groups were comparable in most demographic and preoperative variables. VAS for back and leg pain improved significantly following surgery in both groups. Both groups showed significant improvement in their ODI scores, at one and two years postoperatively. The average length of hospital stay was significantly higher in patients with spondylolisthesis (p-value< 0.01). There was no significant difference between the groups in terms of post-operative complications rates or re-operation rates. Conclusions: Our results indicate that MIS tubular decompression may be an effective and safe procedure for patients suffering from LSS, with or without degenerative stable spondylolisthesis.
Highlights
The initial treatment of lumbar spinal stenosis (LSS) is usually conservative [1], and surgery is indicated when conservative management fails
In recent literature, the routine addition of arthrodesis to decompression for LSS with concomitant stable low-grade degenerative spondylolisthesis remains a matter of debate [7,8,9,10,11,12,13]
A previous study of our group the compared the outcomes of minimally invasive (MIS) decompression between older and younger patients, founded that length of hospital stay (LOS) was significantly higher in the older group [24]
Summary
The initial treatment of lumbar spinal stenosis (LSS) is usually conservative [1], and surgery is indicated when conservative management fails. In recent literature, the routine addition of arthrodesis to decompression for LSS with concomitant stable low-grade degenerative spondylolisthesis remains a matter of debate [7,8,9,10,11,12,13]. The choice of MIS decompression may be a appealing option for patients with lumbar stenosis and concomitant stable low-grade degenerative spondylolisthesis. The routine addition of arthrodesis to decompression for lumbar spinal stenosis (LSS) with concomitant stable low-grade degenerative spondylolisthesis remains controversial. The purpose of this study is to compare the clinical outcome, complication and re-operation rates following minimally invasive (MIS) tubular decompression without arthrodesis in patients suffering from LSS with or without concomitant stable low-grade degenerative spondylolisthesis. Conclusions: Our results indicate that MIS tubular decompression may be an effective and safe procedure for patients suffering from LSS, with or without degenerative stable spondylolisthesis
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