Evaluation of posterior decompressive lumbar surgery for multilevel lumbar spinal canal stenosis with and without fusion

Background There is no consensus regarding the best treatment of patients with multilevel lumbar stenosis. Surgical and invasive procedures are widely used in adults with degenerative lumbar spinal stenosis when conservative treatments fail. However, little is known about the comparative efficacy and safety of these interventions. Aim and objective The aim was to study and evaluate the outcome of surgery for degenerative lumbar canal stenosis (LCS) on a clinical, radiological, and functional basis and to identify whether spinal decompression with fusion has a better effect than decompression alone for patients with degenerative lumbar spinal stenosis or not. Patients and methods A prospective study of 50 patients was carried out at the Department of Neurosurgery, Matarya Teaching Hospital, in whom the lumbar canal stenosis was confirmed. The functional assessment preoperatively and postoperatively was calculated according to the Japanese Orthopedic Association (JOA) score. Results Successful outcomes were significantly associated with posterior decompression and fusion. Clinical outcome assessed according to the JOA score was excellent or good in 68% of the patients who underwent posterior decompression alone and in 84% of patients who underwent posterior decompression with posterolateral fusion. Conclusion Surgical treatment of degenerative lumbar canal stenosis with posterior decompression and spinal fusion yields excellent results as observed on the basis of JOA scoring system.