Short term clinical and functional outcome after posterior lumbar inter body fusion in cases of lumbar canal stenosis by using RODI score assessment

Background: Lumbar canal stenosis (LSS) is a source of significant morbidity and economic burden in the Indian population. Spinal canal compression is the sine qua non of lumbar canal stenosis but whether instrumentation should be done or not is the major dilemma. In this study, we aim to compare the functional outcome of instrumented versus non-instrumented fusions for the treatment of lumbar stenosis along with the post-operative complications and cost-effectiveness of both procedures.Methods: This study was conducted at a tertiary-care medical college and hospital, Aurangabad specializing in post-graduate training, where all patients who underwent surgical treatment between May 2016 and May 2018 were included. Patients were assessed using the modified Oswestry disability index (MODI) and visual analogue scale (VAS). These evaluations were done at 3, 6, 12 and 24 months.Results: We found similar pain relief and stabilization in both the groups in the initial post-operative period, but after 2 years, there was a significant difference (p=0.0001) between the two groups in terms of VAS (back) and MODI score. Complication rate was higher in instrumented patients. Conclusions: Patient selection is the most important thing in the management of lumbar canal stenosis. We believe that, with the flowchart on the management of lumbar canal stenosis, it would help choosing patients better as to who would require instrumented fusion. Non-instrumented fusions might cost less and have fewer complications, but the overall outcome of the patient in the future should be kept in mind.

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Short-Term Efficacy of Epidural Injection of Triamcinolone Through Translaminar Approach for the Treatment of Lumbar Canal Stenosis

Anesthesiology and Pain Medicine ◽

10.5812/aapm.99764 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Saeed Sabbaghan ◽

Elham Mirzamohammadi ◽

Maryam Ameri Mahabadi ◽

Farshad Nikouei ◽

Farhad Rahbarian ◽

...

Keyword(s):

Epidural Injection ◽

Short Term ◽

Lumbar Canal Stenosis ◽

Term Efficacy ◽

Canal Stenosis ◽

Translaminar Approach

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Functional outcome of lumbar canal stenosis treated by decompression and fixation

International Journal of Orthopaedics Sciences ◽

10.22271/ortho.2020.v6.i4k.2416 ◽

2020 ◽

Vol 6 (4) ◽

pp. 755-758

Author(s):

Dr Somashekar ◽

Dr Kiran Kumar ◽

Dr Ragha Midhun Ponnam

Keyword(s):

Functional Outcome ◽

Lumbar Canal Stenosis ◽

Canal Stenosis

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Functional outcome of fenestration discectomy in discogenic lumbar canal stenosis

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20193677 ◽

2019 ◽

Vol 5 (5) ◽

pp. 832

Author(s):

Nitin Lalbabu Singh ◽

Raghavendra Kembhavi ◽

R. Vijayakumaran

Keyword(s):

Functional Outcome ◽

Disc Herniation ◽

Oswestry Disability Index ◽

Radicular Pain ◽

Neurological Deficits ◽

Treatment Modalities ◽

Complete Relief ◽

Lumbar Canal Stenosis ◽

Canal Stenosis

Background: Annual incidence of significant disc herniation causing sciatica ranges from 14% to 15%. Inspite of various treatment modalities available, fenestration discectomy still remain treatment of choice for discogenic lumbar canal stenosis. The objective of our study is to assess functional outcome and complications associated with fenestration discectomy in patients of discogenic lumbar canal stenosis.Methods: Thirty two patients who had unilateral radicular pain with clinicoradiologically confirmed posterolateral disc herniation and who failed to respond to conservative management were treated surgically by fenestration discectomy. Outcome was assessed using Oswestry disability index at 6 months follow up.Results: Patients with neurological deficits underwent fenestration discectomy with complete relief of radicular pain in 17 patients and mild reduction in 5 patients on follow up. 23 patients had recovery from motor symptoms and 25 patients had recovery from sensory symptoms whereas 9 patients still had motor weakness and 7 patients still had sensory deficit. Oswestry disability index (ODI) score used for functional outcome at 6 months postoperatively showed 63% of the patients were having 0 to 20 ODI score with minimal disability, 34% of the patients had score of 21 to 40% with moderate disability, and 3% were having 41 to 60% ODI score with severe disability. One patient had dural tear and two patients had post-operative discitis.Conclusions: Fenestration discectomy is an excellent surgical option for discogenic lumbar canal stenosis. Fenestration discectomy is an easy, economical and effective means of treating lumbar disc prolapse with minimal acceptable complications.

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Functional outcome analysis of lumbar canal stenosis patients post decompression and posterior stabilization with stenosis grading using magnetic resonance imaging

Journal of Physics Conference Series ◽

10.1088/1742-6596/884/1/012146 ◽

2017 ◽

Vol 884 ◽

pp. 012146

Author(s):

M Pili ◽

S D A L Tobing

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Functional Outcome ◽

Outcome Analysis ◽

Resonance Imaging ◽

Posterior Stabilization ◽

Lumbar Canal Stenosis ◽

Canal Stenosis ◽

Functional Outcome Analysis

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Lumbar canal stenosis: Clinical, radiological and functional outcome

Neurology India ◽

10.4103/0028-3886.185384 ◽

2016 ◽

Vol 64 (4) ◽

pp. 684

Author(s):

Hemant Bhartiya

Keyword(s):

Functional Outcome ◽

Lumbar Canal Stenosis ◽

Canal Stenosis

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A PROSPECTIVE STUDY TO EVALUATE THE FUNCTIONAL OUTCOME OF NON- INSTRUMENTED LUMBAR DECOMPRERSSION IN ADULT DEGENERATIVE LUMBAR CANAL STENOSIS [LCS] AND DETERMINE PREDICTIVE FACTORS OF FAVOURABLE OUTCOME

10.36106/paripex/5908752 ◽

2021 ◽

pp. 81-84

Author(s):

Rakesh Prasad ◽

Sunny N Prasad

Keyword(s):

Prospective Study ◽

Functional Outcome ◽

Predictive Factors ◽

Favourable Outcome ◽

Outcome Study ◽

Lumbar Canal Stenosis ◽

Lumbar Decompression ◽

Canal Stenosis ◽

A Prospective Study

AIM AND OBJECTIVES: A prospective study to evaluate the functional outcome of non- instrumented lumbar decompression in adult degenerative lumbar canal stenosis [LCS] and determine predictive factors of favourable outcome. Study details: Patients attending Orthopedic OPD at BARC Hospital, Mumbai, who were operated for adult degerative LCS from June 2017 to May 2019. CONCLUSION: The VAS and Beaujon score were stasistically significant when compared to preoperative and 3 months post operatively

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METHODOLOGY TO SURGICALLY APPROACH FOR LUMBAR CANAL STENOSIS;“WHEN TO” AND “WHEN NOT TO” DO INSTRUMENTAL FUSION- A PROSPECTIVE STUDY.

10.36106/2941493 ◽

2021 ◽

pp. 21-24

Author(s):

Arun Kumar KV ◽

Arun Kumar C ◽

Pradeep E ◽

Venkatachalam K ◽

Arivoli Arivoli ◽

...

Keyword(s):

Functional Outcome ◽

Conservative Management ◽

Lumbar Fusion ◽

Lumbar Vertebra ◽

Deep Infection ◽

Lumbar Canal Stenosis ◽

Vas Score ◽

Dural Sac ◽

Canal Stenosis

Introduction:Lumbar canal stenosis is dened, as an abnormal narrowing of the ligamento-osseous canal of the lumbar vertebra or of the foramina intervertebralis, causing a direct compression or a compromise of either the dural sac or the nerve root or indirectly to their vasculature producing symptoms of radiculopathy or and claudication.Patient whose symptoms do not show improvement after non-surgical or conservative trial, become eligible for surgical relief. AIM: To Prospectively analyze, Canal decompression, interbody Lumbar fusion with or without posterior stabilization with postero-lateral bone grafting, in cases presenting with MRI proven Lumbar Canal Stenosis, not responding to conservative management. Materials and Methods:Our study was done in Chettinad Hospital and Research Institute from January 2016 to December 2020, Follow-up period was for a minimum period of 12 months. 54 patients participated in the study.JOA and VAS score was recorded at the end of 12 months postsurgery to analyze the functional outcome. Results: There were 32 males and 22 females in the study.Our mean male JOA score was pre-operatively 9.88 which improved to 14.8 at the 12th month follow-up. Our mean JOA for females was at 8.3 which improved post operatively to 13.8.The mean VAS score pre-operatively in the men th and women were 7.4 and 8.6 respectively. This, at the 12 month follow up dropped to 0.8 and 1.2 for men and women respectively.The complications encountered in the study patients are Dural tears in 6 patients, supercial infection in 8 patients, Deep infection and Neurological decit in 4 and 3 patients respectively. All of these complications subsequently got resolved without any long term sequelae. Conclusion:In patients with lumbar canal stenosis whose symptoms do not abate, with conservative management, surgical lumbar spinal canal decompression, whether it is single level or dual level, does provide for a good clinico- functional outcome.

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