The Effect of Limited Decompression of Selective Segments in Multilevel Spinal Stenosis

Koh, Young Do

Abstract

Spinal stenosis is one of the degenerative diseases of spine, and frequently involves several segments. However, symptom may be provided by pathology in only one or two segments. Therefore, it is very important to select symptomatic segments when we treat patients with multilevel stenosis surgically. Decompression may be done limitedly to prevent high morbidity and complications associated with extensive decompression and posterolateral fusion. The purpose of this study is to evaluate the effectiveness of limited decompression of selective segments in spinal stenosis. From September, 1993 to August, 1996, 21 patients who underwent limited decompression of only symptomatic segments, were followed up for more than 1 ysar, and the results were assessed according to the criteria of Kim & Kim. The indications of surgery were definite neurologic symptoms, failure of conservative treatments, and no instability. The segments for operation were chosen by symptom, physical examination and radiographic study, and sometimes root block or electromyography were done in case of necessity. The results were followed as: 4 excellent(19%), 13 good(62%), 3 fair(14%), and 1 poor(5%). 1 superficial wound infection developed and was treated without suquelae. Conclusively, limited decompression of selective segments in multilevel spinal stenosis is considered to be useful if selection of level and extent of decomperssion are carefully determined.