title: A Novel Classification and Minimally Invasive Treatment of Degenerative Lumbar Spinal Stenosis.
abstract: OBJECTIVE
  We conducted a novel classification system of degenerative lumbar spinal stenosis (DLSS) based on clinical manifestations and imaging (computed tomography and magnetic resonance imaging) features. We chose different minimally invasive surgical procedures according to our system. Clinical parameters and radiological findings will be assessed in the article.
  
  
  METHODS
  A retrospective study was conducted on 96 patients undergoing minimally invasive surgery for DLSS. We chose different surgical procedures according to our novel classification system based on clinical manifestations, imaging features, and concurrence with other spinal diseases. Clinical parameters and radiological findings were assessed pre- and postoperatively.
  
  
  RESULTS
  The mean follow up period was 24 months (range, 15~36 months). There was a statistically significant improvement in the Visual Analogue Scale (VAS) score of low back pain and leg pain after surgery (p < 0.05). According to the Japanese Orthopaedic Association (JOA) scores, the operation efficacy was excellent in 57 cases, good in 36 cases, and fair in 3 cases. According to Bridwell's criterion, the fusion rate was 96% (48/50) in patients who underwent fusion surgery. There were no cages or pedicle screws related complications.
  
  
  CONCLUSIONS
  Minimally invasive surgical treatment of DLSS has satisfactory outcomes according to the novel classification, but further long-term, prospective, randomized controlled studies involving a larger study group are needed to validate the long-term efficacy.
authors.affiliation: Shanghai Tenth People's Hospital, Tongji University School of Medicine, Department of Orthopedics, Shanghai, China.
authors.forename: Guangfei
authors.initials: G
authors.lastname: Gu
authors.forename: Hailong
authors.initials: H
authors.lastname: Zhang
authors.forename: Shisheng
authors.initials: S
authors.lastname: He
authors.forename: Qingsong
authors.initials: Q
authors.lastname: Fu
authors.forename: Xiaobing
authors.initials: X
authors.lastname: Cai
authors.forename: Xu
authors.initials: X
authors.lastname: Zhou
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Shen
authors.forename: Xin
authors.initials: X
authors.lastname: Gu
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000601:surgery; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D065289:Pedicle Screws; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D013130:Spinal Stenosis / Q000145:classification* / Q000601:surgery*; D016896:Treatment Outcome