Posterior lumbar interbody fusion with spinal decompression using minimally invasive spine surgery in the treatment of symptomatic degenerative spinal stenosis

Abstract

BACKGROUND: Lumbar spinal stenosis occurs predominantly in elderly person as a degenerative progress. It could be acquired such as spondylosis, spondylolisthesis and trauma. Signs and symptoms of lumbar spinal stenosis are low back pain, sciatica, neurogenic intermittent claudication, motor and sensory deficits and reflex changes. Aching spreads over the lumbosacral dermatomes or painful parasthesias can sometime develop. These symptoms may be triggered by walking and producing flexion motion of the lumbar spine such as sitting or crouching forwards and relieved by resting for several minutes. Lumbar spinal stenosis is often the result of advanced degeneration of motion segments of the lumbar spine. Loss of disc height, facet displacement and hypertrophy, spondylosis, and spondylolisthesis, all contribute to impact the spinal canal and intervertebral foramen in lumbar stenosis. Using a minimal invasive surgery (MIS) make a better postoperative condition, provides benefits such as earlier mobilization, shorter hospital stay, reduced hospital costs, and morbidity reduction. CASE PRESENTATION: We present a 67-year-old woman with low back pain that has occurred for 2 years and had been worsening for the past 3 months. She described the pain as an intermittent ache down on her leg, the pain was severe and worsened when the patient is standing, sitting, or walking for a long time. The pain severity was measured by Visual Analog Scale (VAS), graded between 7/10 and 9/10. She also complained numbness from the bilateral gluteal region to the lateral side of lower extremities, when she feels too tired. After the examination, the patient agreed to undergo the suggested operative procedure and gave the consent at the hospital. CONCLUSION: Minimally invasive spine surgery using posterior lumbar interbody fusion can be recommended in our opinion for symptomatic degenerative spinal stenosis with segmental instability because the benefits such as lower back pain relief, improvement of the motoric & sensoric function, early mobilization compared to classic PLIF technique.