Clinical Comparison between Microsurgical Decompression and Lumbar Interbody Fusion with Instrumentation for Lumbar Stenosis.

Lee, Kuk Jin; Lee, Jung Chung; Kim, Keun Su

Original Article

Journal of Korean Neurosurgical Society 2003;33(5): 454-459.

Kuk Jin Lee, Jung Chung Lee, Keun Su Kim

Department of Neurosurgery, Research Institute for Clinical Medicine, Chonbuk National University Medical School Hospital, Jeonju, Korea.

ABSTRACT

OBJECTIVE
We report clinical results of the patients who received microsurgical decompression procedure(bilateral partial laminectomy and medial facetectomy: Group A) compared with lumbar interbody fusion with instrumentation(total laminectomy, interbody fusion and pedicle screw fixation: Group B). METHODS: From March 1996 to December 2000, twenty patients with symptomatic lumbar stenosis underwent microsurgical decompression and twenty-five patients underwent lumbar interbody fusion by two operators. Two groups of patients were compared retrospectively in respect to the mechanical back pain, leg pain, motor weakness, sensory hypesthesia(numbness) and clinical outcomes. The mean follow-up period was 30 months.
RESULTS
In Group A, mechanical back pain, leg pain, motor weakness, and sensory hypesthesia were improved in 72.2%, 69%, 80%, 44.4% and 70%, 71%, 83.3%, 50% respectively in Group B. Clinical outcomes was excellent or good in 80% in Group A and 84% in Group B and no differences in clinical parameters between Groups were demonstrated. CONCLUSION: We recommend microsurgical decompression for the patients suffering from symptomatic lumbar stenosis with stable spine because microsurgical decompression provided a satisfactory clinical results equivalent to lumbar interbody fusion with instrumentation.

Key Words: Lumbar stenosis; Microsurgical decompression; Lumbar interbody fusion