[Short-term effectiveness of interlaminar lumbar instrumented fusion through a small incision for lumbar spinal stenosis].
OBJECTIVE
To evaluate the short-term effectiveness of local laminectomy and interlaminar lumbar instrumented fusion (ILIF) through a small incision for lumbar spinal stenosis.


METHODS
Between November 2009 and January 2011, 16 patients with lumbar spinal stenosis were treated by local laminectomy and ILIF through a small incision. There were 7 males and 9 females with an average age of 52.8 years (range, 49-67 years). Sixteen patients had lumbar degenerative stenosis with an average disease duration of 4 years and 7 months (range, 2 years-9 years and 4 months). Four cases complicated by lateral recessus stenosis, 3 by lumbar disc herniation. Involved segments included L3,4 in 2 cases, L4,5 in 4 cases, L5, S1 in 4 cases, L3,4 and L4,5 (double segments) in 2 cases, L4,5 and L5, S1 (double segments) in 4 cases. The effectiveness was evaluated with the pre- and post-operative Visual Analogue Scale (VAS) scores, Oswestry Disability Index (ODI). The cross-sectional areas of spinal canal were measured by CT scanning and were compared between pre- and post-operation.


RESULTS
The average operative time was 47 minutes (range, 35-80 minutes); the average blood loss was 145 mL (range, 120-350 mL); and the average hospitalization days were 7.8 days (range, 4-15 days). Cerebrospinal fluid leakage occurred in 1 case, and healing of incisions by first intention was achieved in the others. The patients were followed up 12-22 months (mean, 14.8 months). CT scanning showed interspinous fusion in 14 cases and possible fusion in 2 cases after operation, with an average fusion time of 4.6 months (range, 3-10 months). The postoperative VAS score, ODI, and cross-sectional area were significantly improved when compared with preoperative values (P < 0.05).


CONCLUSIONS
The ILIF can promote fusion between spinous processes, provide spine stabilization, and protect the spinal cord. The procedure has small incision, simple method of fixation and fusion.
Department of Orthopedics, Baoji Hospital of Traditional Chinese Medicine, Baoji Shaanxi, 721003, P.R.China. wsf710715@sina.com
Shaofei
S
Wang
Jianhu
J
Chao
Jianmin
J
Wei
Fernando G
FG
Diaz
D000368:Aged; D016025:Bone Transplantation; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D007796:Laminectomy / Q000379:methods; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010147:Pain Measurement; D011859:Radiography; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods*; D013130:Spinal Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome