Outcome of Wide Laminectomy and Instrumented Fusion in Management of Degenerative Lumbar Spinal Stenosis

Kelany, Omar Abdelwahab; Saleh, Mohammed Khalid; Mohamed Tolba, Bahy Mohsen; Ali, Elsayed Mohamed Selim

doi:10.21608/zumj.2025.403391.4051

Outcome of Wide Laminectomy and Instrumented Fusion in Management of Degenerative Lumbar Spinal Stenosis

Document Type : Original Article

Authors

¹ Professor of Orthopedic and Spine Surgery department, Surgery, Faculty of Medicine, Zagazig University, Egypt

² Assistant Professor of Orthopedic and Spine Surgery department, Surgery, Faculty of Medicine, Zagazig University, Egypt

³ Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University, Egypt

⁴ Lecturer of Orthopedic and Spine Surgery department, Surgery, Faculty of Medicine, Zagazig University, Egypt

10.21608/zumj.2025.403391.4051

Abstract

Background: One of the most frequent reasons for lumbar spine surgery in older individuals is degenerative lumbar spinal stenosis (LSS). This study aimed to assess the functional and radiographic outcomes of wide laminectomy and instrumented fusion in management of degenertive LSS. Methods: Twenty four patients who had degenerative lumbar spinal stenosis with low back pain and/or leg pain refractory to medical treatment; underwent wide laminectomy and instrumented fusion in this prospective study with follow up period of two years. Assessment was done in terms of Oswestry Disability Index (ODI), neurogenic symptoms, and visual analogue scale scores (VAS) for back and leg pain. Patient Satisfaction Index (PSI) was used as a measure to assess patients' experiences and satisfaction. Anteroposterior, lateral and dynamic views radiology of the lumbosacral spine to assess pre and post operative instability and lumbar lordosis. Finally, computed tomography (CT) was done postoperatively to evaluate the degree of fusion. Results: Comparing preoperative, 2 months postoperative and final outcome of VAS for back pain, VAS for leg pain and ODI among the operated patients (N=24), there was significant change among them with follow up (p value < 0.05). The lumbar lordosis (LL) increased also from a mean of 53.08±11.78 to 59.25±10.77 with significant difference (p value <0.05). Conclusion: Wide laminectomy and instrumented fusion in degenerative LSS offers excellent functional and radiographic outcome with less risk of postoperative instability.

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