Decompressive laminectomy for lumbar stenosis: Review of 65 consecutive cases from Tema, Ghana

Abstract

Background: There have been previous reports describing patients with lumbar stenosis (LS) in West Africa; however, to date no such report has been published from Ghana. Objective: To provide data on the pattern of lumbar stenosis and the effects of decompressive lumbar laminectomy (DLL) on the clinical course of LS in Tema. Methods: Sixty-five consecutive patients who underwent DLL for lumbar stenosis over between January 2001 and December 2004 had their medical records analyzed. The parameters of interest included demographics, pre and post surgical clinical status utilizing the modified low back pain clinical scoring system, operative procedure and complications. Results: Sixty-five patients (36M, 29F) with a mean age of 51 years constituted the series. All had failed conservative treatment; each patient was operated on once at our institution. Eighty nine percent of the series presented with neurogenic claudication and accompanying motor and sensory deficits. Twenty-seven patients (41.5%) underwent bilateral DLL; the rest underwent unilateral DLL. The mean preoperative score for the series was 2.3; that for males 2.6, females 1.9 (p>0.05). There was a significant difference between patients <60years and >60years. The mean postoperative score for the series was 8.7. There was a significant difference between preoperative and postoperative scores of series. No mortality was recorded The complication rate was 15%. Conclusion: In Tema, decompressive lumbar laminectomy for lumbar stenosis achieves significant clinical improvement with attendant low morbidity and mortality rates in patients who have failed conservative treatment. Accompanying disc excision and or fusion are required in only a small minority of patients.