251 - Non-fusion Dynamic Stabilization in Addition to Decompressive Laminect...

#251 Non-fusion Dynamic Stabilization in Addition to Decompressive Laminectomy for Spinal Stenosis with Degenerative Lumbar Scoliosis

Lumbar Therapies and Outcomes

Poster Presented by: S. Lee

Author(s):

S.E. Lee (1)
T.-A. Jahng (2)

(1) Seoul National University College of Medicine, Neurosurgery, Seoul, Korea, Republic of
(2) Seoul National University College of Medicine, Seoul, Korea, Republic of

Abstract

Background: Spinal stenosis with degenerative lumbar scoliosis (DLS) mostly occurs in the elderly population causing pain in the legs and back, claudication, and spinal deformity. Surgical management includes decompression and fixation with fusion either with an anterior or posterior approach to prevent further progression of the deformity.

Objective: To analyze surgical outcomes after non-fusion stabilization in addition to decompressive laminectomy for spinal stenosis with a mild to moderate degree of DLS

Methods: Twenty-eight patients (21 women and 7 men with a mean age of 65.3years) with spinal stenosis and DLS who underwent non-fusion stabilization with the DynesysTM system in addition to decompressive laminectomy were included in this study. Medical records and radiographic studies were reviewed to access clinical and radiological outcomes and surgery-related complications.

Results: The mean follow-up period was 29.1 months. Fifty-nine segments were decompressed and stabilized without fusion in 28 patients; One segmental stabilization in 8 patients (28.6%: L4/5), 2 segmental stabilizations in 11 patients (39.3%: L3/4/5), 3 segmental stabilizations in 7 patients (25.0%: L2/3/4/5 in 6, L3/4/5/S1 in 1), and 4 segmental stabilizations in 2 patients (7.1%: L2/3/4/5/S1 in 1, L1/2/3/4/5 in 1). Radiographically, lumbar scoliotic angle was 13.7° before surgery, 3.4° after surgery, and 5.6° at last follow-up with a statistical significance (p < 0.001). Lumbar lordosis and range of motion was preserved. The visual analog scale for leg and back pain decreased, and Oswestry disability index improved after surgery. There were no newly developed neurological deficits or aggravation of neurological symptoms.

Conclusion: Non-fusion stabilization in addition to decompressive laminectomy resulted in a safe and effective procedure for elderly patients with lumbar stenosis with a mild to moderate degree of scoliosis angle (< 30°). Statistically significant improvement of the clinical outcome was obtained at last follow-up with no progression of the degenerative scoliosis.