Clin Orthop Surg.  2020 Jun;12(2):187-193. 10.4055/cios19110.

Results of Decompression Alone in Patients with Lumbar Spinal Stenosis and Degenerative Spondylolisthesis: A Minimum 5-Year Follow-up

• Ha DH
• Kim TK
• Oh SK
• Cho HG
• Kim KR
• Shim DM

• KMID: 2500863
• DOI: http://doi.org/10.4055/cios19110

Abstract

Background
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.
Methods
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.
Results
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.
Conclusions
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.

Keyword

Decompression; Spondylolisthesis; Spinal stenosis