The Journal of Bone and Joint Surgery, Vol 77, Issue 7 1036-1041, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Degenerative lumbar spinal stenosis. Decompression with and without arthrodesis
D Grob, T Humke and J Dvorak
Spine Unit, Schulthess Hospital, Zurich, Switzerland.
We prospectively evaluated the results of decompression of the spine, with
and without arthrodesis, for the treatment of lumbar spinal stenosis
without instability in forty-five patients (twenty-one men and twenty-four
women) who had been managed between November 1989 and November 1990. The
average age at the time of the operation was sixty-seven years (range,
forty-eight to eighty-seven years). The patients were randomly assigned to
one of three treatment groups (fifteen patients in each group) according to
when they were admitted to the hospital. Group I was treated with
decompression with laminotomy and medial facetectomy; Group II, with
decompression and arthrodesis of the most stenotic segment; and Group III,
with decompression and arthrodesis of all of the decompressed vertebral
segments. All of the operations were performed by the same surgeon. The
average duration of follow-up was twenty-eight months (range, twenty-four
to thirty-two months). All three groups had a significant improvement in
the distance that the patients were able to walk at the time of the latest
follow-up examination compared with before the operation (p < 0.001 for
Group I, p < 0.002 for Group II, and p < 0.005 for Group III). With
the numbers available, there were no significant differences in the results
among the three groups with regard to the relief of pain (p = 0.25 for
Group I compared with Group II, p = 0.36 for Group II compared with Group
III, and p = 0.92 for Group I compared with Group III).(ABSTRACT TRUNCATED
AT 250 WORDS)
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