COMPARISON OF THREE DIFFERENT SURGICAL TREATMENT PROCEDURES USED IN THE TREATMENT OF LUMBAR SPINAL STENOSIS; RETROSPECTIVE CLINICAL STUDY

Özet

Objective: We aimed to compare the clinical results of three different surgical approaches (bilateral decompression via unilateral approach (BDUA), BDUA + fusion with unilateral instrumentation, total laminectomy and fusion with bilateral instrumentation) in the treatment of lumbar spinal stenosis. Materials and Methods: The clinical and surgical aspects of 51 surgically treated patients with lumbar spinal stenosis were retrospectively reviewed. Results: Duration of surgery, amount of bleeding, pain assessment visual analogue scale, length of stay (LOS), duration of mobilization, time required for return to work, complications and cost were analyzed. The mean postoperative low back VAS score was calculated to be 7.1 in group 1, 8.3 in group 2, and 8.6 in group 3. Significant decreases were found in the VAS scores of each group (p<0.005). In group 2 and group 3, delayed mobilization was the main cause of prolonged LOS. Conclusion: In this study, comparing these three surgical procedures, we evaluated the VAS scores of the low backs and legs of the patients separately, and found no significant difference in the VAS scores of any group. Similarly, durations of surgery, blood loss during surgery, and the time required for return to work make BDUA more advantageous. Presence of severe low back pain and risk of iatrogenic instability may dictate the addition of unilateral fusion and instrumentation to surgery in selected cases.