Surgery for lumbar stenosis: Technique and outcome

Abstract

Lumbar stenosis is a very frequent condition among the elderly, which inflicting serious disturbances in locomotion and the general well-being of the patients. From 1992 to 2000, we have performed surgery on 321 cases of lumbar spine diseases, which included 180 lumbar stenosis. Our primary method used in this period was fenestration, which preserves the lamina, spinous process, facets, interspinous and the supraspinous ligaments. The technique allows selective and effective decompression of the common dural sac and the individual root sleeves in the foramen. Long-term outcome was assessed using questionnaires and interview of the patients. One hundred and thirty-five patients had a postoperative follow-up longer than 2 years (2 to 8 years 11 months, with a mean of 3 years and 11±2 months). Seventy-four percent of the patients undergoing fenestration reported markedly improved status of the walking capacity, and 94.1% expressed overall satisfaction with the results. This less invasive method of surgery yields reliable alleviation of the neurological function and ADL. The symptomatology, anatomical concept/classification, radiological findings, indication, techniques and results of surgical treatment are summarized.