Lumbar spinal canal stenosis in patients with diffuse idiopathic skeletal hyperostosis: Surgical outcomes after posterior decompression surgery without spinal instrumentation

Purpose of the study: To understand surgical outcomes, based on standardized tools, after surgery of lumbar spinal canal stenosis in patients aged 65 years and older. Methods: A cross-sectional study was undertaken in 58 elderly patients before and after surgery. Demographic data, procedures, perioperative comorbidities, preoperative and postoperative pain intensity, primary activities of daily living, quality of life, and fear avoidance were collected at baseline. All patients were followed up to 6 and 12 months after operation. Results: Following surgery, there was a significant reduction in the VAS scale (for pain severity) and fear avoidance beliefs (FAB) questionnaire scale (P<0.001), and a significant increase in the 36-Item Short Form Health Survey (SF-36) index and the Barthel Index for Activities of Daily Living (ADL), which assesses functional independence) (P<0.001). Implication: The present study suggests that surgery in elderly patients is effective for the treatment of spinal stenosis, in those patients who did not respond well to conservative treatment.

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Microendoscopic Decompression Surgery for Lumbar Spinal Canal Stenosis via the Paramedian Approach: Preliminary Results

Global Spine Journal ◽

10.1055/s-0032-1319774 ◽

2012 ◽

Vol 2 (2) ◽

pp. 087-093 ◽

Cited By ~ 10

Author(s):

Kazunori Nomura ◽

Munehito Yoshida

Keyword(s):

Spinal Canal ◽

Spinous Process ◽

Japanese Orthopaedic Association ◽

Spinal Canal Stenosis ◽

Decompression Surgery ◽

Lumbar Spinal Canal Stenosis ◽

Canal Stenosis ◽

The Mean ◽

Lumbar Spinal Canal ◽

Lumbar Spinal

The objective of this study was to evaluate the efficacy of a microendoscopic spinal decompression surgical technique using a novel approach for the treatment of lumbar spinal canal stenosis (LSCS). The following modifications were made to the conventional microendoscopic bilateral decompression via the unilateral approach: the base of the spinous process was first resected partially to secure a working space, so as not to separate the spinous process from the lamina. The tip of the tubular retractor was placed at the midline of the lamina, where laminectomy was performed microendoscopically. A total of 126 stenotic levels were decompressed in 70 patients. The mean operating time per level was 77.0 minutes, and the mean intraoperative blood loss per level was 15.0 mL. There were no dural tears or neurological injuries intraoperatively. Fracture of the spinous process was detected postoperatively in two patients, both of whom were asymptomatic. All patients could be followed up for at least 12 months. Their median Japanese Orthopaedic Association (JOA) score improved significantly from 16 points preoperatively to 27.5 points after the surgery (p < 0.001). The case series showed that the modifications of the technique improved the safety and ease of performance of the microendoscopic decompression surgery for LSCS.

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