The authors reviewed 114 patients of degenerative lumbar spinal stenosis who were admitted to the Department of Orthopaedic Surgery, Severance Hospital from January 1986 to January 1991.
The male to female ratio was 1:1.9 and the mean age of patient was 54 years(range 42-78). Follow-up ranged from 2 years to 5 years 4 months with a mean of 2 years 8 months. Patients could be divided into two group, degenerative lumbal stenosis
(50
patients, 44%) and with degenerative spondylolisthesis(64 patients, 56%).
Of the 90 patients who had degenerative lumbar stenosis, twenty four patients(21%) was treated conservatively, fifteen patients(13%) underwent posterolateral fusion without instrumentation after posterior lecompression and fifty one patients(45%)
underwent posterolateral fusion with segmental spinal instrumentation using transpedicular screw after extensive posterior decompression. Among the cases applied transpedicular screw, 29 cases were Cotrel-Dubousset system, 19 cases were Steffe
system
and 3 cases were others.
For the remaining 24 patients who had degenerative lumbar stenosis with degenerative spondylolisthesis underwent anterior interbody fusion after discectomy.
According to Kim's criteria91991), ten patients(42%) were classified as good in conservative treatment group but there was no excellent result, and seventy eight patients987%) were classified as excellent or good in surgical treatment groups.
in conclusion, for the treatment of degenerative lumbar spinal stenosis, anterior interbody fusion or posterolateral fusion after extensive decompression of stenosed neural elements are considered more reliable and satisfactory treatment than
conservative treatment.
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