Degenerative stenosis is the most common type of spinal canal stenosis.
It develops secondary to a combination of factors that include hypertrophy of facet joints, vertebral osteophytes, hypertrophy of ligamentum flavum and bulging of annulus fibrosus.
The canal narrowing in this condition is not uniform at several levels throughout the spinal axis but rather is narrowed segmentally.
From January 1986 to may 1990, authors had treated surgically for 34 cases of degenerative lumbar stenosis involving at least 3 segments.
There were 18 males and 16 females. Their average age was 54.1 years(range 41-75).
The aims of surgery were to provide better quality of life through the improvement neurogenic claudication, back or leg pain, and activity of daily living.
Follow up was obtained on 30 patients at an average 28.2 months(range 12-65 months).
@ES Results were as follows:
@EN 1. The main surgical indications were severe neurogenic claudication (less than 200 meters) and/or intractable low back or radiating pain.
2. In addition to well known pathology such as hypertrophy of facets and annular bulging, severe venous engorgement just like varicose veins surrounding spinal canal and/or nerve root runnel was noted in 4 patients.
3. Most of patients were treated with adequate posterior decompression, posterolateral fusion and transpedicular screw fixation. But, 6 patients were not instrumented.
4. Authors assessed the results according to the changes of neurogenic claudication, low backache, radiating pain, activity of daily living, grade of satisfaction by patients and neurologic deficit before and after surgery. Results in our 30
cases
were
excellent in 3 cases(10%), good in 16 cases(53.3%), fair in 8 cases(26.7%) and poor in 3 cases(10%).
5. Complications were relatively high.
6. It seems rigid fixation with instrument is valuable in elderly patients with high instability.
7. Poor prognostic factors were obesity, industrial patients and severe osteoporosis.
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