J Korean Soc Spine Surg.  1998 Nov;5(2):278-283.

Selective Microscopic Decompression for Lumbar Spinal Stenosis with Osteoporosis: More than 3 Years Follow Up

• Shim DM
• Kim TG
• Song HH
• Cho YW

Abstract

OBJECTS: There was a trend 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 the range of excision of anatomical structure and reduced the decompressin level in the multiple lesions and the incidence of spinal fusion. The purpose of this study were to assess the outcome of this procedure in 3 years follow up and to identify the clinical features of the patients and technical aspects of the operation that were associated with a poor outcome. MATERIALS AND METHODS: Twenty-one patients were identified as having had a microscopic decompression without arthrodesis, for degenerative lumbar spinal stenosis over 60 years or their who had osteoporosis with Saville's index 2 or higher. The follow up period was more than 3 years. The clinical results was evaluated by Kim's criteria.
RESULTS
Eleven cases were above good results in two levels involved 14 cases, 2 cases above good results in three levels involved 5 cases and 1 case above good results in four levels involved 2 cases. In the cases of affected duration, 7 cases are less than 1 year or more than 5 years each 6 cases and 2 cases were above good results by the criteria. We concluded that the long-term outcome of decompressive surgery in the elderly is good; it does not differ from that reported for younger patients .
CONCLUSIONS
Selective microscopic decompression is one of the effective method for the elderly patients or patients with osteoporosis in addition to multiple stenotic lesions.

MeSH Terms

Aged
Arthrodesis
Decompression*
Follow-Up Studies*
Humans
Incidence
Osteoporosis*
Spinal Fusion
Spinal Stenosis*
Spine