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KMID : 0388720090160030194
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Journal of Korean Society of Spine Surgery
2009 Volume.16 No. 3 p.194 ~ p.201
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Posterior Dynamic Stabilization with Selective Wide Decompression for Multilevel Lumbar Stenosis - Preliminary Result -
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Kim Ki-Tack
Lee Sang-Hoon
Suk Kyung-Soo
Lee Jung-Hee
Kwack Yoon-Ho
Seo Eun-Min
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Abstract
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Study Design A prospective study
Objectives: We wanted to assess the clinical outcomes of posterior dynamic stabilization with selective wide decompression for treating multilevel lumbar stenosis in old age.
Summary of the Literature Review Deciding on the segments to be operated on is challenging problem for old age patients with multilevel lumbar stenosis. There have been no reports on posterior dynamic stabilization with selective wide decompression for treating multilevel lumbar stenosis.
Materials and Methods : We evaluated 18 patients who underwent posterior dynamic stabilization with selective decompression for multilevel disc degeneration and spinal stenosis. The mean age was 70.2 years and mean follow-up was 15.1 months. We evaluated the segmental angle, the range of motion (ROM) and pedicle screw loosening. The clinical results were evaluated according to the operative time, blood loss, the visual analogue scale (VAS) for the back pain and leg pain and and the Oswestry disability index (ODI).
Results: The mean number of operated segments was 2.16. The lordosis of the lumbar and operated segments showed no significant difference. However, the ROM of the total lumbar spine and the operation segment was significantly decreased from 36.8 to 24.3 and 22.9 to 13.1, respectively. The ROM for the adjacent segment did not show a significant difference. A radiolucent line around the pedicle screw appeared at 22 screws (19.3%) out of a total 114 screws. The VAS for back and leg pain were improved from 7.5 and 8.6 to 2.3 and 2.1, respectively. The ODI was improved from 41.5 to 13.4.
Conclusions: The initial clinical outcomes were favorable after posterior dynamic stabilization with selective decompression. This procedure could be considered to be a useful option for treating multilevel stenosis in old age patients.
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KEYWORD
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Multilevel lumbar stenosis, Selective decompression, Posterior dynamic stabilization
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