Department of Orthopaedic Surgery, Wonkwang University Sanbon Hospital, Gunpo, Korea.
Department of Orthopedic Surgery, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea.
Clin Orthop Surg. 2020 Jun;12(2):187-193. doi: 10.4055/cios19110. Epub 2020 May 14.
Surgical treatment consisting of decompression and fusion is generally known to produce good clinical results for lumbar spinal stenosis with degenerative spondylolisthesis. However, the clinical outcome of decompression alone, without fusion, remains unclear, and long-term follow-up results are scarce. This study aimed to retrospectively analyze the 5-year clinical results of decompression only in patients with lumbar spinal stenosis and degenerative spondylolisthesis.
Among the patients diagnosed as having lumbar spinal stenosis with degenerative spondylolisthesis, 36 patients who underwent decompression without fusion and were followed up for minimum 5 years were included in this study. The average follow-up period was 7.2 years, and the mean age of patients was 63.2 years. Visual analog scale (VAS) score and Oswestry disability index (ODI) were investigated pre- and postoperatively, and also radiologic displacement and instability were measured. In addition, patients who needed fusion or redecompression at the decompression site postoperatively were also investigated.
VAS score and ODI improved from an average of 7.8 points and 57 points preoperatively, respectively, to 1.4 points and 19 points at 5 years postoperatively, respectively. The degree of radiologic displacement increased from an average of 5.1 mm preoperatively to 6.4 mm at the final follow-up. Radiological instability was detected in five patients. Two patients (9.5%) required fusion.
The long-term follow-up results revealed that satisfactory clinical outcomes were obtained with decompression alone, without fusion, for patients with lumbar spinal stenosis and degenerative spondylolisthesis.
对于伴有退行性滑脱的腰椎管狭窄症，手术治疗包括减压和融合通常被认为能取得良好的临床效果。然而，单纯减压而不融合的临床效果尚不清楚，且长期随访结果也很少。本研究旨在回顾性分析单纯减压治疗伴有退行性滑脱的腰椎管狭窄症患者的 5 年临床结果。
在诊断为伴有退行性滑脱的腰椎管狭窄症患者中，纳入了 36 例接受单纯减压而未融合且随访至少 5 年的患者。平均随访时间为 7.2 年，患者的平均年龄为 63.2 岁。术前和术后均调查了视觉模拟评分（VAS）和 Oswestry 功能障碍指数（ODI），并测量了影像学位移和不稳定性。此外，还调查了术后在减压部位需要融合或再次减压的患者。
VAS 评分和 ODI 分别从术前的平均 7.8 分和 57 分改善至术后 5 年的平均 1.4 分和 19 分。影像学位移程度从术前的平均 5.1 毫米增加到最终随访时的 6.4 毫米。发现 5 例存在影像学不稳定性。2 例患者（9.5%）需要融合。
长期随访结果表明，对于伴有退行性滑脱的腰椎管狭窄症患者，单纯减压而不融合可获得满意的临床效果。
