Selective Microscopic Decompression for Multi-level Lumbar Spinal Stenosis: More than 5 Years Follow Up

Song, Ha Heon; Shim, Dae Moo; Kim, Dong Churl; Kim, Tae Kyun; Shin, Ho Sik

Abstract

STUDY DESIGN: A rectrospective study of microscopic lumbar decompressions was performed elderly patients suffering from multiple level of lumbar stenosis.
OBJECTIVES
The Purpose of this study were to assess the outcome of this procedure performed only microscopic decompression on multiple lesions in 5 years follow up and to identify the clinical features of the elderly patients with multiple stenosis. SUMMARY OF BACKGROUND DATA: There was a common to perform fusion and instrumentation in spinal stenosis surgery, because of extensive decompression and instability. However the introduction of microscope in spine operation can minimize lesions and the incidence of spinal fusion.
MATERIALS AND METHODS
Twenty-one patients were identified as having had a microscopic decompression without arthrodesis, for degenerative lumbar spinal stenosis over 60 years. The follow up period was more than 5 years. The clinical results was evaluated by Low-Back Outcome scale.
RESULTS
Ten cases were above good results in two levels involved 14 cases, 4 cases above good results in three levels involved 6 cases, one case above good results in four levels. In the cases of affected duration, 4 of 5 cases in less than 1 year, 8 of 12 cases in 1 to 5 years, 3 of 4 cases in more than 5 years were above good results by the criteria. We had calculated the average score (54.8) and concluded that the long-term outcome of decompressive surgery in the elderly is good.
CONCLUSION
Selective microscopic decompression is one of the effective method for the elderly patients or patients with osteoporosis in addition to multiple stenotic lesions. And preoprative root block is also useful for selective microscopic decompression.