Degenerative Spondylolisthesis Accompanying LSS: Do We Need Fusion?

Kafrelsheikh University52 enrolled

Overview

This study aimed to compare clinical results of decompression alone using minimal invasive unilateral laminotomy for bilateral decompression versus classical decompression and instrumentation and fusion.

The term "lumbar spinal stenosis" (LSS) describes the anatomical narrowing of the spinal canal, which occurs in older people because of spinal ageing. Initial treatment is usually medical. Surgical management is recommended for patients with failed non-surgical trials. As claudication is always the main complain, lumbar canal decompression is the traditional surgical treatment. Although adding instrumentation and fusion is not uncommon and widely used. In the literature, the benefit of fusion, is treating instability that causes degenerative spondylolisthesis, improve back pain if present, and avoid slippage progression, which possibly will occur with generous decompression and disruption of the posterior column.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Degenerative Spondylolisthesis Lumbar Spinal Stenosis Fusion

Interventions

Unilateral laminotomy decompressionPROCEDURE

Patients underwent unilateral laminotomy decompression.

Decompression and fusionPROCEDURE

Patients underwent a posterior decompression, (either with or without preservation of midline bands) was followed by instrumentation using pedicle screws with rods and intervertebral fusion device.

Eligibility

Sex: ALLMin age: 50 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age \> 50 years. * Both sexes. * Patients with symptoms of lumbar spinal stenosis (LSS) (neurogenic claudication) confirmed by magnetic resonance imaging (MRI), and a degenerative spondylolisthesis measuring at least 3 mm at the stenotic level on a plain X-ray. Exclusion Criteria: * Patients with excessive foraminal stenosis (a deformed nerve root in the intervertebral foramen). * Thoracolumbar scoliosis of greater than 20 degrees. * Patients with significant instability in plan radiography dynamic study. * Patients who had previous spine surgery at lumbar region.

Locations (1)

Kafrelsheikh University

Kafr ash Shaykh, Kafrelsheikh, Egypt

Outcomes

Primary Outcomes

Assessment of low back pain

Low back pain was assessed using the Oswestry Disability Index (ODI), 10-question self-report questionnaire to measure functional disability and quality of life. It yields a percentage score from 0% (no disability) to 100% (severe disability).

Time frame: 14 months after the procedure

Secondary Outcomes

Degree of pain

Each patient was instructed about leg pain assessment with the numeric rating scale (NRS) score. NRS (0 represents "no pain" while 10 represents "the worst pain imaginable").

Time frame: 14 months after the procedure

Incidence of complications

Incidence of complications were recorded.

Time frame: 14 months after the procedure

Data from ClinicalTrials.gov

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