| Analysis of Surgical Outcome of Lumbar Stenosis Over 2 Year Follow-Up |
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Kwang-Ju Bae, M.D., Eun-Seok Choi, M.D., Eul-Soo Jung, M.D., Byung-Gil Son, M.D., Jong-Hyun Shin, M.D., Myung-Jin Kim, M.D., and Yong-Chul Chi, M.D. |
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epartment of Neurosurgery, Bogang Hospital, Daegu, Korea |
| 2년 이상의 추적 관찰을 한 요추관 협착증의 수술적 결과의 분석 |
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배광주,최은석,정을수,손병길,신종현,김명진,지용철 |
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보강병원 신경외과 |
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| Abstract |
Objective: To analyze the surgical outcome according to the types and methods of operation for lumbar spinal stenosis.
Methods: A total of 226 patients operated for lumbar spinal stenosis were divided into 5 types: central, subarticular, foraminal, extraforaminal, and double crush. Patients were treated with decompression or fusion - anterior lumbar interbody fusion(ALIF), posterior lumbar interbody fusion with pedicle screw fixation(PLIF), posterolateral fusion with pedicle screw fixation(PLF), stand alone cage between January 1998 and December 2002(mean follow up: 4.7 years). The surgical result was analyzed using Bogang score rating system according to the 4 questionnaires: medication, ability of daily living, degree of improvement, satisfaction.
Results: Among 226 patients enrolled initially, 16 patients were died prior to reaching follow-up and 3 patients were lost for contact. Outcome were available for 206 patients(117 women, 89 men, mean age 60). Numbers of types of stenosis were as follow: central 77(37.4%), subarticular 34(16.5%), foraminal 63 (30.6%), extraformainal 30(14.6%) and double crush 2(1.0%). Among 206patients, 70cases were underwent decompression only, PLIF in 118, cage alone in 10, ALIF in 4, PLF were 4. Overall success rate is 70.9%. The success rate according to types of stenosis was as follows: Central(72.7%), subarticular(79.4%) foraminal(55.6%), extraforaminal(86.7%) and 2 cases of double crush were successful. Success rate of central and subarticular stenosis is similar between decompression and fusion. In foraminal stenosis, decompression showed poor result in contrast with fusion. Most of the operation in extraforaminal stenois were performed with fusion and showed better result than other types of stenosis.
Conclusion: Decompression is undesirable methods for foraminal stenosis but decompression for central and subarticular stenosis showed good results as well as instrumentation method. And extraforaminal stenosis, PLIF was done in most of case, showed the most favorable outcomes. |
| Keywords:
Spinal stenosis․Decompression․Fusion․Posterior lumbar interbody fusion |
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