Functional outcome of surgical treatment for multilevel lumbar spinal stenosis.
BACKGROUND
There is no consensus regarding the best treatment of patients with multilevel lumbar stenosis. We evaluated the clinical and radiological findings in 41 patients with complex degenerative spinal stenosis of the lumbar spine who were treated surgically.


METHODS
Between 1997 and 2003, 41 patients suffering from degenerative lumbar spinal stenosis were included in a prospective clinical study. The spinal stenosis was multilevel in all patients and in 13 of them there was degenerative scoliosis, in 18 there was degenerative spondylolisthesis, and in 10 there was segmental instability. Plain radiographs, MRI and/or CT myelograms were obtained preoperatively. The patients were assessed clinically with the Oswestry disability index (ODI) and visual analog scale (VAS). Surgery included wide posterior decompression and fusion using a trans-pedicular instrumentation system and bone graft.


RESULTS
After a mean follow-up of 3.7 (1-6) years, the patients' clinical improvement on the ODI and VAS was statistically significant. Recurrent stenosis was not observed, and 39 of 41 patients were satisfied with the outcome. 3 patients with improvement initially had later surgery because of instability.


CONCLUSIONS
The above-mentioned technique gives good and long lasting clinical results, when selection of patients is done carefully and when the spinal levels that are to be decompressed are selected accurately.
Zouboulis
Panagiotis
P
Department of Orthopedics, Patras University Hospital. Rio-Patras, GR-26504. Greece.
Panagiotis
Zouboulis E
ZE
Karageorgos
Athanasios
A
Athanasios
Karageorgos
K
Dimakopoulos
Panagiotis
P
Panagiotis
Dimakopoulos
D
Tyllianakis
Minos
M
Minos
Tyllianakis
T
Matzaroglou
Charis
C
Charis
Matzaroglou
M
Lambiris
Elias
E
Elias
Lambiris
L
D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000379:methods; D004185:Disability Evaluation; D017586:Diskectomy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009192:Myelography; D011446:Prospective Studies; D020127:Recovery of Function; D012008:Recurrence; D012600:Scoliosis / Q000150:complications / Q000175:diagnosis; D013130:Spinal Stenosis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D013168:Spondylolisthesis / Q000150:complications / Q000175:diagnosis; D016896:Treatment Outcome