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Abstract
Spinal stenosis is a localized narrowing of the spinal canal from structural abnormality of bony components. Posterior decompression only provide relief of the pain and preservation of restoration of neurologic function, but simultaneous posterolateral fusion with internal fixation is needed for prevention of spinal instability after wide posterior decompression. From January 1985 to May 1990, 72 patients of lumbar spinal stenosis had undergone operations with posterior decompression or posterolateral fusion with spinal instrumentation at the department of Orthopaedic Surgery, College of Medicine, InJe University. The following results were obtained. 1. There were 22 males and 50 females. 2. The average age was 55 years ranging from 22 years to 73 years of age.
3. Major cause of spinal stenosis was degenerative change, 91.6%. 4. Chief complaints on admission were low back pain and paresthesia of lower extremity in 70 cases, and intermittent claudication in 50 cases. 5. Myelograms and myelo-enhanced computerized tomography were done when all patients had severe symptoms and positive neurologic sings, and the hour-glass defect was common findings of myelograms, and facet joint hypertrophy was common on C-T. 6. The most common stenotic level was at L4-5, 38.9%. 7. Posterior decompression only were carried out on 50 patients, and simultaneous posterolateral fusion with instrumentation were 22 patients, Fixateur Internae 18 eases, Luque system 3 cases, F.V.M. 1 case. 8. The patients with simulataneous posterolateral fusion with instrumentation could be done early ambulation and activity after brace application 5.3 days earlier than the patients with posterior decompression alone. 9. Post-operative pain and neurologic signs were not relieved, so fair by Kikaldy-Willis criteria in 7 cases, but relieved later after discharge by long-tertn follow-up.
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