A study of surgical treatment of lumbar canal stenosis. Laminectomy with postero-lateral spinal fusion.:Laminectomy with Postero-Lateral Spinal Fusion

概要

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Fifty-five patients with lumbar canal stenosis who underwent posterior spinal decompression with or without P-L spinal fusion were reviewed to investigate clinically and radiographycally. Twenty-four patients were female and 31 were male. The mean age was 52.8 years (range, 23-73). The average follow-up time was 2.4 years (range, 0.5-6.4). Forty-seven patients were treated with decompression and spinal fusion, and 8 patients were treated with decompression alone without spinal fusion. The postoperative results were evaluated wity JOA score. Regarding radiographycal approach, we measured the angle displacement and horizontal displacement using Dupuis' method. The mean preoperative JOA score was 12.5 points and the mean postoperative JOA score was 23.0 points. The recovery rate was 63.6%. High incidence of poor results were noted in postoperative group. Forty-three patients (92%) had a good union of the graft bone and four patients (8%) were found to have pseudoarthrosis on follow-up roentgenographic evaluation. It does not appear that the P-L spinal fusion induces instability of other lumbar spine. The concomitant spinal fusion should be routinely employed to patients with extensive spinal decompression.
西日本整形・災害外科学会の論文