[Surgical treatment for lumbar spinal stenosis by different methods].

OBJECTIVE

To discuss the relationship between decompression methods of lumbar spinal stenosis and outcomes.

METHODS

From September 1996 to March 2007, 68 patients with degenerative lumbar spinal stenosis were investigated retrospectively. There were 40 males and 28 females with the mean age of 52.8 years (ranging from 32 to 78 years old). And the average history was 51 months. According to Hansraj classification of lumbar spinal stenosis and levels response to symptom,the classic lumbar spinal stenosis were treated with complete laminectomy and foramintomy (18 cases in group A), hemilaminectomy and foreminotomy (11 cases in group B), complete fenestration and foraminotomy (17 cases in group C); and other patients with complicated lumbar spinal stenosis (22 cases in group D) were treated with decompression and intervertebral fusion and internal fixation. The clinical results of all patients were analyzed according to JOA score (15 scoring method).

RESULTS

All patients were followed up with an average of 64 months (ranging from 8 months to 11 years). At final follow-up,the improvement rate of JOA score in the group A,B,C,D was respectively (51.2 +/- 26.6)%, (60.7 +/- 21.1)%, (59.3 +/- 23.1)% and (59.1 +/- 22.7)%. These data were significantly difference than that of preoperative (P < 0.001).

CONCLUSION

CT and MRI results combining with clinical symptom and sign is the key to determine decompressive extent; lumbar stability is the key to determine fixation and intervertebral fusion in treating lumbar spinal stenosis.