Lumbar Nerve Root Canal Decompression for Degenerative Lumbar Disease.

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Thirty-seven patients (32 men and 16 women) who received decompressive surgery extending to the foraminal region between December 1989 and December 1993 were studied. The average age at the time of operation was 63 years, and the average postoperative follow-up period was 20 months, with 22 patients (60%) being followed for over one year. On preoperative investigation, latefal displacement and nerve block as determined by selective radiculograhy (SRG) as well as a marked reduction or absence of perineural fat tissue in the intervertebral foraminal region on MRI, were considered abnormal. In general en block laminectomy (laminoplasty) was performed for nevrve root canal decompression.Fifty nerve root canal decompressive procedures were performed, since nine patients required surgery at two or more sites. The operative findings included 37 cases of osteophyte and or disc protrusion and six cases of ala-transverse impingement. Postoperatively, 35 patients (94%) were either pain-free or had slight residual pain in the lower extremities. In patients with lower extremity pain due to degenerative lumbar disease, it is important to detect abnormalities of the interforamina on MRI and SRG. En block laminectomy (laminoplasty) is an effective procedure because it does not result in structural failure and it allows adequate observation of the nerve root pathway.
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