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J Korean Neurosurg Soc. 2013 Jan;53(1):19-25. doi: 10.3340/jkns.2013.53.1.19. Epub 2013 Jan 31.

A comparison of the clinical outcomes of decompression alone and fusion in elderly patients with two-level or more lumbar spinal stenosis.

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  • 1Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Korea.

Abstract

OBJECTIVE:

We compared the results of two surgical techniques by retrospective study of 60 elderly patients (65 years or older) who underwent either decompression alone or fusion for the treatment of two-level or more lumbar spinal stenosis.

METHODS:

During the period of 2003 and 2008, two-level or more decompression alone or fusion was performed for lumbar spinal stenosis by three surgeons at our institution. Patients were allocated to two groups by surgical modality, namely, to a decompression group (31 patients) or a fusion group (29 patients). Overall mean age was 71.1 years (range, 65-84) and mean follow-up was 5.5 years (range, 3-9). A retrospective review of clinical, radiological, and surgical data was conducted.

RESULTS:

No significant difference between the two groups was found with respect to age, follow-up period, surgical levels, or preoperative condition. At the last follow-up, correction of lumbar lordotic angle (determined radiologically) was better in the fusion group. However, clinical outcomes including visual analogue scale, Oswestry Disability Index, and the Odom's criteria were not significantly different in the two groups. On the other hand, surgical outcomes, such as, operation time, estimated blood loss, and surgical complications were significantly better in the decompression alone group.

CONCLUSION:

Our findings suggest that decompressive laminectomy alone achieves good outcomes in patients with two-level or more lumbar spinal stenosis, associated with an advanced age, poor general condition, or osteoporosis.

KEYWORDS:

Laminectomy; Spinal fusion; Spinal stenosis

PMID:
23440621
PMCID:
PMC3579077
DOI:
10.3340/jkns.2013.53.1.19
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