title: Low risk for vertebral slipping after decompression with facet joint preserving technique for lumbar spinal stenosis.
abstract: The incidence and magnitude of vertebral slipping after decompression for central lumbar spinal stenosis were determined in a prospective study of 60 consecutive patients. Mean patient age was 64 (35-83) years, and 35 patients were men. In all cases, laminectomy was performed using a facet joint preserving undercutting technique. Plain radiographs were obtained before and 1 year after surgery. Vertebral slipping and disc degeneration were measured. Preoperative degenerative olisthesis was seen in 19 of the 60 patients. Further slipping had occurred in 6 of these patients by 1 year postoperatively. Of the remaining 41 patients, only 1 showed a postoperative slipping. Improvement concerning leg pain was reported by 45 patients, and there was no difference in patients with or without postoperative slipping. It is concluded that decompression with a facet joint preserving technique yielded a low risk for postoperative vertebral slipping. The risk for slip was higher in patients with preoperative degenerative olisthesis but was still less than 1/3. Vertebral slipping did not influence the outcome of the operation at 1 year. Our results do not support the routine use of spinal fusion in connection with decompression for lumbar spinal stenosis.
authors.affiliation: Department of Orthopedics, University Hospital, Lund, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Jönsson
authors.forename: M
authors.initials: M
authors.lastname: Akesson
authors.forename: K
authors.initials: K
authors.lastname: Jonsson
authors.forename: B
authors.initials: B
authors.lastname: Strömqvist
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000009:adverse effects*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011859:Radiography; D012306:Risk; D013130:Spinal Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000601:surgery*