The Outcomes Of Surgical Treatment For Lumbar Spinal Stenosis And Analysis Of Correlative Influencing Factors

Objective: This study was conducted to compare the effects of decompressive surgery versus decompressive, fusion and instrumentation surgery for lumbar spinal stenosis, evaluate the correlative factors which influenced the results.Methods: This study compared 2 groups of 57 adult patients, who underwent surgical treatment for symptomatic lumbar spinal stenosis. The patients of each group were received either decompressive surgery (Group A), or decompressive, fusion and instrumentation surgery (Group B). All the patients were followed for an average of 28.9 months.The mean ages of the patients in Group A and Group B were 57.9±12.1 and 60.1±10.0 years, respectively. All the patients were evaluated by using Japanese Orthopaedic Association (JOA) scoring system , Visual Analogue Scale (VAS) and Self-rating Depression Scale (SDS) in the latest follow-up observation. The roentgenographic parameters of were measured and compared in 56 spines: lumbar lordosis (L1-S1) and relative intervertebral height.Results: At the final follow-up, the average improvementive ratio of JOA scores in Group A and Group B were 73.3±36.7% and 71.4±38.2%(P>0.05). the percent of excellent and good result were 80% (Group A) and 81%(Group B) (P>0.05). The mean decreasing scores of the Visual Analogue Scale for pain were 5.64 and 5.73 respectively, (P>0.05). The relative intervertebral heights of Group B at the latest follow-up were 33.4±8.9%, which were higher than Group A (26.7±8.0%)significantly (P<0.05) The lumbar lordosis was significantly increased in Group A (P<0.05), from 37.0±12.3 to 40.9±13.2, however which in Group B has no significant changes (P>0.05). The history of spinal operation, complication and the SDS score et al were significantly associated with improvementive ratio of JOA scores (P<0.10).Conclusion: The short-term effects of decompressive surgery and decompressive, fusion and instrumentation surgery for lumbar spinal stenosis were similar. fusion and instrumentation surgery can maintain a higher intervertebral height, but the recovery degree of lumbar lordosis of which was less than another, The history of spinal operation, complication and depression can influence the outcomes of surgery.