Microdecompression and uninstrumented single-level fusion for spinal canal stenosis with degenerative spondylolisthesis.
METHODS
A retrospective review was completed on 21 patients who had a "least invasive" (one or two level) microdecompression and uninstrumented single-segment lumbar fusion for spinal canal stenosis with degenerative spondylolisthesis.


OBJECTIVE
To determine whether a "least invasive" approach to lumbar spinal canal stenosis and degenerative spondylolisthesis would yield acceptable results.


BACKGROUND
The prevailing surgical technique for symptomatic spinal canal stenosis with degenerative spondylolisthesis is a wide midline decompression and instrumented fusion.


METHODS
On an average of 38 months postoperatively, 21 patients were personally assessed on four scores: 1) their overall satisfaction with the outcome of surgery, 2) an analog back and leg pain scale, 3) a functional evaluation scale, and 4) Ferguson (upshot) anterior-posterior lumbosacral and lateral flexion-extension radiographs.


RESULTS
The overall satisfactory outcome on all four scales was 16 (76%) of 21. Twenty of twenty-one patients had relief of their claudicant leg pain; the overall fusion rate was 18 (86%) of 21. Two of three patients with a pseudarthrosis had a successful outcome on the patient-oriented outcome (1, 2, and 3) scales (excluding the radiograph scale), and one was a failure. One patient with a solid fusion was a failure because of continuing back pain. One patient with a solid fusion was a failure because of continuing leg pain. The overall satisfactory outcome on the nonradiographic scales was 18 of 21, for an 86% patient satisfaction rate.


CONCLUSIONS
In this retrospective study, a "least invasive" surgical approach to lumbar degenerative spondylolisthesis with spinal canal stenosis causing claudicant leg pain produced acceptable results.
McCulloch
J A
JA
Department of Orthopaedics, Summa Health Systems, Rootstown, Ohio, USA.
D019299:Decompression, Surgical / Q000191:economics / Q000379:methods*; D062109:Dermatologic Surgical Procedures; D004210:Dissection; D005500:Follow-Up Studies; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008159:Lumbar Vertebrae / Q000473:pathology; D008279:Magnetic Resonance Imaging; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion / Q000191:economics / Q000379:methods*; D013130:Spinal Stenosis / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D013168:Spondylolisthesis / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome