Degenerative Spondylolisthesis Accompanying LSS: Do We Need Fusion?

Kafrelsheikh University

Status: Completed

Conditions: Fusion; Lumbar Spinal Stenosis; Degenerative Spondylolisthesis

Treatments: Procedure: Unilateral laminotomy decompression; Procedure: Decompression and fusion

Study type: Observational

Funder types: Other

Identifiers

NCT07410871

KFSIRB200-889

Details and patient eligibility

About

This study aimed to compare clinical results of decompression alone using minimal invasive unilateral laminotomy for bilateral decompression versus classical decompression and instrumentation and fusion.

Full description

The term "lumbar spinal stenosis" (LSS) describes the anatomical narrowing of the spinal canal, which occurs in older people because of spinal ageing.

Initial treatment is usually medical. Surgical management is recommended for patients with failed non-surgical trials. As claudication is always the main complain, lumbar canal decompression is the traditional surgical treatment.

Although adding instrumentation and fusion is not uncommon and widely used. In the literature, the benefit of fusion, is treating instability that causes degenerative spondylolisthesis, improve back pain if present, and avoid slippage progression, which possibly will occur with generous decompression and disruption of the posterior column.

Enrollment: 52 patients

Sex: All

Ages: 50+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age > 50 years.
• Both sexes.
• Patients with symptoms of lumbar spinal stenosis (LSS) (neurogenic claudication) confirmed by magnetic resonance imaging (MRI), and a degenerative spondylolisthesis measuring at least 3 mm at the stenotic level on a plain X-ray.

Exclusion criteria

• Patients with excessive foraminal stenosis (a deformed nerve root in the intervertebral foramen).
• Thoracolumbar scoliosis of greater than 20 degrees.
• Patients with significant instability in plan radiography dynamic study.
• Patients who had previous spine surgery at lumbar region.

Trial design

52 participants in 2 patient groups

Group 1 (Unilateral laminotomy decompression)

Description:

Patients underwent unilateral laminotomy decompression.

Treatment:

Procedure: Unilateral laminotomy decompression

Group 2 (Decompression and fusion)

Description:

Patients underwent a posterior decompression, (either with or without preservation of midline bands) was followed by instrumentation using pedicle screws with rods and intervertebral fusion device.

Treatment:

Procedure: Decompression and fusion