Global lumbar spinal canal stenosis | ||||
| The Egyptian Orthopaedic Journal | ||||
| Volume 55, Issue 4, October 2020, Page 253-257 | ||||
| DOI: 10.4103/eoj.eoj_68_21 | ||||
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| Authors | ||||
| Mohamed Wafa; Khaled Salama; Ahmed Toureih; Ahmed Abdelati | ||||
| Abstract | ||||
| Background Global stenosis is any type of spinal canal stenosis with more than two levels of stenosis (three or more). The usual course of spinal stenosis is benign and chronic, and most of the patients followed up show insignificant changes over years. In addition, many patients may respond to conservative treatment and physiotherapy, but regarding the global canal stenosis, the natural history is different. Patients and methods A case series retrospective study was conducted on 64 patients who were divided into two groups. Decompression and fixation was the standard procedure, and the method of fusion in group A was lateral bilateral intertransverse processes bone grafting whereas in group B was interbody fusion using cages. Results In each group separately, statistics showed that there is a strong relationship between 1-month postoperative Oswestry disability index (ODI) improvements, which resulted in progressive improvement as long as it was improved from the baseline. Moreover, at the final follow-up, the authors found a strong significant relationship between ODI and visual analog scale improvement. Spinal canal diameter preoperatively had insignificant relationship with postoperative improvement. Fusion obtained at 6-month assessment was more than 90% of the fused levels in group B and almost the same or less in groups A, but at 12-month assessment. No significant difference was found between the two groups regarding the preoperative or postoperative results regarding the ODI or visual analog scale at 1-month follow-up or up to 2-year follow-up. The blood loss and operative time showed significant differences between the two groups (more blood loss and longer operative time in group B). Conclusion Global spinal canal stenosis is better treated with surgical decompression whatever the method of fusion used. | ||||
| Keywords | ||||
| fixation and fusion; Spinal Canal; Stenosis | ||||
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