Results in the surgical treatment of degenerative lumbar spinal stenosis: A retrospective analysis

Aim: The intention of this retrospective analysis with follow-up was to assess results after decompressive or additional stabilising operations in the clinical setting of degenerative lumbar spinal stenosis. Method: 74 patients, operated upon from 1995 to 2001, were investigated clinically, radiologically and with questionnaire score 1 to 8 years (mean 2.5) postoperatively. All data were compared and evaluated with the preoperative findings. The results of the group with decompressive operations were compared with those for the group with additional stabilising operations. Results: The patients with stabilising operations showed an improvement of 78.3% on the visual analogue scale and of 76.1% on the Oswestry score. The patients with decompressive operations showed an improvement of 91.7% on the visual analogue scale and of 75.0% on the Oswestry score. The difference between the two groups was not significant. There was a poorer outcome for previously operated patients or patients with a prolonged course of disease. Conclusion: The choice of the operative treatment with regard to spinal stenosis requires a differentiated preoperative diagnostic procedure in accord with the respective living situation and age of the patients. Instability in terms of degenerative spondylolisthesis, lumbar scoliosis as well as intraoperatively recognised or generated instability has to be additionally stabilised with an instrumented fusion in regard to the functional aspect of the stenosis.