Decompression fusion surgery and minimally invasive microsurgical decompression in patients with single-segment lumbar spinal stenosis.

Unlabelled: There are few studies comparing clinical efficacy of decompression/fusion surgery (transforaminal lumbar interbody fusion (TLIF) + transpedicular interbody fusion) and minimally invasive microsurgical decompression (MMD) in patients with single-segment lumbar spinal stenosis.

Objective: To compare the results of TLIF + transpedicular interbody fusion and MMD in patients with single-segment lumbar spinal stenosis.

Material And Methods: A retrospective observational cohort study included medical records of 196 patients (100 (51%) men, 96 (49%) women). Age of patients ranged from 18 to 84 years. Mean postoperative follow-up period was 20.1±6.7 months. Patients were divided into 2 groups: group I (control) included 100 patients who underwent TLIF + transpedicular interbody fusion, group II (study) included 96 patients who underwent MMD. We analyzed pain syndrome and working capacity using visual analogue scale (VAS) and Oswestry Disability Index (ODI), respectively.

Results: Analysis of pain syndrome in both groups after 3, 6, 9, 12 and 24 months clearly demonstrated stable relief of pain syndrome (VAS score) in the lower extremities. In group II, VAS score of lower back and leg pain was significantly higher in long-term follow-up period (after 9 months or more) compared to the 1 group (<0.05). In long-term follow-up period (after 12 months), there was significant decrease in degree of disability (ODI score) in both groups (<0.001) without between-group differences. We assessed achievement of treatment goal in 12 and 24 months after surgery in both groups. The result was significantly better in the 2 group. At the same time, some respondents failed to achieve the final clinical goal of treatment in both groups (group I - 8 (12.1%), group II - 2 (3%) patients).

Conclusion: Analysis of postoperative outcomes in patients with single-segment degenerative lumbar spinal stenosis revealed similar clinical effectiveness of TLIF + transpedicular interbody fusion and MMD regarding decompression quality. However, MMD was associated with less traumatization of paravertebral tissues, blood loss, fewer unwanted phenomena and earlier recovery.