A novel classification and minimally invasive treatment of degenerative lumbar spinal stenosis

Guangfei Gu, Hailong Zhang, Shisheng He, Qingsong Fu, Xiaobing Cai, Xu Zhou, Xiaolong Shen, Xin Gu
2014 Turkish Neurosurgery  
a result of the degenerative cascade (3). To our knowledge, how to do the individualized surgery for lumbar stenosis is still controversial. In this article, we conducted a novel classification system of DLSS based on clinical manifestations and imaging (Computed Tomography (CT) and Magnetic Resonance Imaging (MRI)) features. We chose different minimally invasive surgical procedures according to our system. Clinical parameters and radiological findings will be assessed in the article. █
more » ... article. █ InTRODuCTIOn Spinal stenosis is a narrowing of the spinal canal with encroachment on the neural structures by surrounding bone and soft tissue (9). Patients with spinal stenosis typically present with intermittent neurogenic claudication, or a combination of lower extremity pain, tension and weakness that occurs with walking or standing but is relieved with sitting down or lumbar flexion. The pathoanatomy of degenerative lumbar spinal stenosis (DLSS) is very complicated, including bulging discs, zygapophyseal joint hypertrophy, buckling or hypertrophy of the ligaments, and spondylolisthesis as AIm: 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. mATERIAl and 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. COnCluSIOn: 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. KEywORDS: Decompression, Degenerative lumbar spinal stenosis, Minimally invasive surgery, Transforaminal lumbar interbody fusion q r c o d e
doi:10.5137/1019-5149.jtn.9173-13.2 pmid:26956823 fatcat:p2nobtlsljb55lnc36awz52rei