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KMID : 1150320160120020242
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Journal of Korean Society of Geriatric Neurosurgery
2016 Volume.12 No. 2 p.242 ~ p.247
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A Comparison of Clinical Outcomes after Decompression and Fusion with Instrumentation for Lumbar Single Level Stenosis in Elderly
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Lee Ji-Hun
Park Jong-Tae
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Abstract
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Objective: To assess the clinical outcomes of elderly patients with L4-5 spinal stenosis who had undergone decompression alone or with arthrodesis, we retrospectively analyzed the results of the surgical techniques.
Methods: We analyzed the clinical outcomes of 32 patients, who were divided into two groups, decompression alone (16 patients) and fusion with instrumentation (16 patients). We assessed for their pain using a visual analog scale (VAS) preoperatively and at 4 weeks, 6 months, and at 1 and 2 years, postoperatively, and the Oswestry disability index (ODI) at last follow-up. Clinical outcome and satisfaction was accessed using Odom criteria.
Results: The score of VSA was improved at both groups (decompression alone: 7.81 points before the operation, and 5.5 and 5 four weeks and six months after the operation/fusion: 7.94 point, 4.25 and 4 before operation and four weeks and six months, respectively). After 2 years, VAS was improved 3.5 in decompression alone group and 2.31 in fusion group. Subjective satisfaction was higher in patients who had received fusion with instrumentation (75%) than patients who received simple decompressive laminectomy (56.75%).
Conclusion: There was no significant correlation in clinical outcome and patients’ subjective satisfaction with VAS, ODI and Odom criteria and little difference in the level of improvement in spinal stenosis patients, regardless of either they had been treated between decompression alone and fusion with instrumentation for lumbar single level stenosis in elderly.
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KEYWORD
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Stenosis, Elderly, Decompression, Fusion with instrumentation, Clinical outcome
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