Journal of Orthopedics and Joint Surgery

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VOLUME 5 , ISSUE 1 ( January-June, 2023 ) > List of Articles

Original Article

Functional Outcomes of Posterior Decompression in Patients with Neurogenic Claudication due to Lumbar Canal Stenosis

Rex Chandrabose, S Vijaya Anand, Satish Kumar, Prem Anand, Harish Kumar

Keywords : Lumbar canal stenosis, Neurogenic claudication, Neurogenic Claudication Outcome Score, Posterior decompression

Citation Information : Chandrabose R, Anand SV, Kumar S, Anand P, Kumar H. Functional Outcomes of Posterior Decompression in Patients with Neurogenic Claudication due to Lumbar Canal Stenosis. 2023; 5 (1):7-11.

DOI: 10.5005/jp-journals-10079-1104

License: CC BY-NC 4.0

Published Online: 03-01-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Background: Degenerative lumbar canal stenosis (LCS) is one of the frequently encountered problems in elderly. The long-term outcomes of posterior spinal decompression (PSD) on relief of neurogenic claudication (NC) due to LCS remain unclear. The aim of our study is to assess the functional outcomes of posterior decompression in patients with NC due to lumbar canal stenosis eliminating various heterogeneous factors. Materials and methods: A longitudinal prospective study conducted in 20 patients of homogenous group of age 60–80 years and other medical conditions who had undergone PSD from June 2018 to May 2020 at Rex Ortho Hospital adhering to inclusion and exclusion criteria with stable spine. Patients were assessed with Neurogenic Claudication Outcome Score (NCOS) and Japanese Orthopedic Association Score (JOAS) at preoperative and postoperative period. Results: At the end of the first year 85% had excellent outcome, 10% had good outcome, and 5% had fair outcome based on NCOS and JOAS. No patients had poor outcome or resurgery. Delayed wound healing was in one patient, and no radiological changes such as instability or further degenerative changes were identified. Conclusion: Posterior spinal decompression in patients with NC due to isolated lumbar canal stenosis yields excellent results based on NCOS and JOAS. Selection of patient is very important and careful assessment of other associated local or general problem may influence the outcome.


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  1. Katz JN, Dalgas M, Stucki G, et al. Diagnosis of lumbar spinal stenosis. Rheum Dis Clin N Am 1994;20(2):471–482. DOI: 10.1016/j.berh.2009.11.001
  2. Niggemeyer O, Strauss JM, Schlitz KP. Comparison of surgical procedures for degenerative lumbar spinal stenosis: a meta-analysis of literature from 1975–1995. Eur Spine J 1997;6(6):423–429. DOI: 10.1007/BF01834073
  3. Issack PS, Cunninghan ME, Pumberger M, et al. Degenerative lumbar stenosis: evaluation and management. J Am Acad Orthop Surg 2012;20(8):527–535. DOI: 10.5435/JAAOS-20-08-527
  4. Patel CK, Truumees E. Spinal stenosis: pathophysiology, clinical diagnosis, and differential diagnosis. In: Herkowitz HN, Garfin SR, Eismont FJ, Bell GR, Balderston RA. Rothman–Simeone the Spine. Philadelphia: Elsevier Saunders; 2011. p. 1064–1077.
  5. Suri P, Rainville J, Kalichman L, et al. Does this older adult with lower extremity pain have the clinical syndrome of lumbar spinal stenosis? JAMA 2010;304(23):2628–2636. DOI: 10.1001/jama.2010.1833
  6. Antoniadis A, Ulrich N, Schmid S, et al. Decompression surgery for lumbar spinal canal stenosis in octogenarians; a single center experience of 121 consecutive patients. Br J Neurosurg 2016;31(1):67–71. DOI: 10.1080/02688697.2016.1233316
  7. Weiner BK, Fraser RD, Peterson M. Spinous process osteotomies to facilitate lumbar decompressive surgery. Spine 1999;24(1):62–66. DOI: 10.1097/00007632-199901010-00015
  8. Bae HW, Rajae SS, Kanim LE. Nationwide trends in the surgical management of lumbar spinal stenosis. Spine (Phila Pa 1976) 2013;38(11):916–926. DOI: 10.1097/BRS.0b013e3182833e7c
  9. Hirabayashi K, Miyakawa J, Satomi K. Operative result and postoperative progression of ossification among patients with ossification of cervical posterior longitudinal ligament. Spine (Phila Pa 1976) 1981;6:354–64. DOI: 10.1097/00007632-198107000-00005
  10. Muoghalu ON, Nwadinigwe CU, Iyidobi EC, et al. Early functional outcome of posterior spinal decompression for lumbar spinal stenosis at a Tertiary Health Institution, South East Nigeria. J Biosci Med 2018;6(7):1–14. DOI: 10.4236/jbm.2018.67001
  11. Gelalis ID, Arnaoutoglou OC, Christoforou G, et al. Prospective analysis of surgical outcomes in patients undergoing decompressive laminectomy and posterior instrumentation for degenerative lumbar spinal stenosis. Acta Orthop Traumatol Turc 2010;44(3):235–240. DOI: 10.3944/AOTT.2010.2278
  12. Sanderson PL, Wood PL. Surgery for lumbar spinal stenosis in old people. J Bone Joint Surg Br 1993;75(3):393–397. DOI: 10.1302/0301-620X.75B3.8496206
  13. Leonardi MA, Zannetti M, Min K. Extent of decompression and incidence of postoperative epidural haematoma among different techniques of spinal decompression in degenerative lumbar spinal stenosis. J Spinal Disord Tech 2013;26(8):407–414. DOI: 10.1097/BSD.0b013e31824a03eb
  14. Rajasekaran S, Thomas A, Kanna R, et al. Lumbar spinous process splitting decompression provides equivalent outcomes to conventional midline decompression in degenerative lumbar canal stenosis. Spine 2013;38(20):1737–1743. DOI: 10.1097/brs.0b013e3182a056c1
  15. Amalan RA, Nallakumar S, Devendran R, et al. Comparative study of functional outcome analysis and extent of paraspinal muscle damage between lumbar spinous process splitting decompression and conventional midline decompression for lumbar canal stenosis. Int J Sci Stud 2016;4(8):31–34. DOI: 10.1186/1471-2377-12-101
  16. Azimi P, Mohammadi HR, Montazeri A. An outcome measure of functionality in patients with lumber spinal stenosis: a validation study of the Iranian version of Neurogenic Claudication Outcome Score (NCOS). BMC Neurol 2012;12:101. DOI: 10.1186/1471-2377-12-101
  17. Postacchini F, Cinotti G. Bone growth after surgical decompression for lumbar spinal stenosis. J Bone Joint Surg Br 1992;74(6):862–869. DOI: 10.1302/0301-620X.74B6.1447247
  18. Nath R, Middha S, Gupta AK, et al. Functional outcome of surgical management of degenerative lumbar canal stenosis. Indian J Orthop 2012;46(3):285–290. DOI: 10.4103/0019-5413.96380
  19. Kanafani ZA, Dakdouki GK, El-Dbouni O, et al. Surgical site infections following spinal surgery at a tertiary care center in Lebanon: incidence, microbiology, and risk factors. Scand J Infect Dis 2006;38(8):589–592. DOI: 10.1080/00365540600606440
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