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Journal of Orthopaedic Surgery and Research

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Open Access 01-12-2019 | Laminectomy | Research article

Selective versus multi-segmental decompression and fusion for multi-segment lumbar spinal stenosis with single-segment degenerative spondylolisthesis

Authors: Wei Sun, Cheng Xue, Xian-ye Tang, Hu Feng, Feng Yuan, Kai-jin Guo, Jie Zhao

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2019

Abstract

Background

Lumbar spinal stenosis, often accompanied by degenerative spondylolisthesis, is one of the most common conditions in the elderly. Decompression and fusion is a well-accepted treatment for single-segment lumbar spinal stenosis with degenerative spondylolisthesis; however, the treatment for multi-segment lumbar spinal stenosis with single-segment degenerative spondylolisthesis (MLSS) remains controversial. The objective of this study is to compare the effectiveness of selective decompression and fusion to multi-segmental decompression and fusion for MLSS.

Methods

A total of 42 patients suffering from MLSS who underwent surgery between June 2012 and January 2015 were included in this analysis. Of the 42 patients with minimum 3-year follow-up, 22 underwent selective decompression and fusion, and 20 patients underwent multi-segmental decompression and fusion. Age, gender, symptom duration, operative time, blood loss, the number of decompressed segment and fused segment, and complication were compared between the two groups. The visual analog scale (VAS), Oswestry Disability Index (ODI) and Short Form 36 (SF-36) were used to assess efficacy.

Results

Operative time, blood loss, and the number of fused segment in multi-segmental decompression and fusion group were greater than those in selective decompression and fusion group (P < 0.01). The VAS, ODI, and SF-36 scores at 1-year follow-up and 3-year follow-up were significantly improved compared with those preoperatively in both groups (P < 0.01) but were not significantly different between the two groups at each time point (P > 0.05). There was no iatrogenic spinal instability in the decompressed segments in selective decompression and fusion group, while three patients developed postoperative instability at the adjacent segments above the fused segments in multi-segmental decompression and fusion group at 3-year follow-up.

Conclusions

Selective decompression and fusion is a safe and effective method for the treatment of MLSS, with the advantages of shorter operative time, less blood loss, and more preservation of spinal motion segments when compared with multi-segmental decompression and fusion.

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Title: Selective versus multi-segmental decompression and fusion for multi-segment lumbar spinal stenosis with single-segment degenerative spondylolisthesis
Authors: Wei Sun
Cheng Xue
Xian-ye Tang
Hu Feng
Feng Yuan
Kai-jin Guo
Jie Zhao
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Laminectomy
Spondylolisthesis
Spinal Stenosis
Published in: Journal of Orthopaedic Surgery and Research / Issue 1/2019
Electronic ISSN: 1749-799X
DOI: https://doi.org/10.1186/s13018-019-1092-2

At a glance: The ONWARDS insulin icodec trials

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Selective versus multi-segmental decompression and fusion for multi-segment lumbar spinal stenosis with single-segment degenerative spondylolisthesis

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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