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54. Jahrestagung der Norddeutschen Orthopädenvereinigung e. V.

Norddeutsche Orthopädenvereinigung

16.06. bis 18.06.2005, Hamburg

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Decompression and instrumented fusion for lumbal stenosis and degenerative spondylolisthesis

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  • corresponding author G. Klages - Allgem. Krankenhaus St. Georg, Chirurgisch-traumatologische Klinik, Neurochirurgie, Hamburg
  • G. Manthei - Hamburg
  • U. Koch - Hamburg
  • J. Pinnow - Hamburg

Norddeutsche Orthopädenvereinigung. 54. Jahrestagung der Norddeutschen Orthopädenvereinigung e.V.. Hamburg, 16.-18.06.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05novP15

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/nov2005/05nov066.shtml

Published: June 13, 2005

© 2005 Klages et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Problem

The management of patients with lumbar stenosis and degenerative spondylolisthesis has two aspects: at first the sufficient decompression of the neural elements and secondly to guarantee the stability.

Material. A consecutive series of 244 patients with lumbar stenosis and/or degenerative spondylolisthesis were retrospectively reviewed. The examination of these patients was performed initially after surgery and thereafter at 3-months intervals. Clinical outcome was analyzed by Prolo scale. The follow-up period was in average 36 months.

Methods

In all patients with lumbar stenosis and/or degenerative spondylolisthesis an extensive decompression was performed, Spondylodesis with autologous bone impacted intercorporelly and pedicle screws followed decompression in all cases.

Results

Based on Prolo scale, an excellent or good 1-year outcome was achieved in 73,4% of patients. Moderate improvement could be found in 25,5% and 1,1% of the patients had no benefit from the surgery. The rate of good outcome was in cases with lumbar stenosis 78,6% and in cases with degenerative spondylolisthesis 77,0%. However, patients with previous spinal surgery showed an improvenemt in 66,2%. Interbody fusion could be proved in 90% using x-ray or CT-scan. Surgical revision was necessary in 3,2% because of radicular lesion due to incomplete decompression or incorrect position of the pedicle screws. Additional surgery because instability in the adjacent vertebral segment was performed in 7,4%.

Discussion

The results of our study indicate that the outcome in cases with lumbar stenosis and/or degenerative spondylolisthesis is excellent or good in more than 75% of patients after surgery with extensive decompression and instrumentated spondylodesis.