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

Konovalov NA, Brinyuk ES, Kaprovoy SV, Nazarenko AG, Strunina YuV, Zakirov BA, Kudymets MO, Stepanov IA. Decompression fusion surgery and minimally invasive microsurgical decompression in patients with single-segment lumbar spinal stenosis. Burdenko's Journal of Neurosurgery. 2023;87(3):13‑19. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20238703113

Доказательная гастроэнтерология: pro et contra

Актуальные вопросы педиатрической практики

Использование инфографики авторами научных работ

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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^st group (p<0.05). In long-term follow-up period (after 12 months), there was significant decrease in degree of disability (ODI score) in both groups (p<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^nd 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.

Keywords:

single-segment lumbar stenosis

minimally invasive microsurgical decompression

decompression fusion surgery

clinical results

radiological results

adverse events

Authors:

N.A. Konovalov

Burdenko Neurosurgical Center

ORCID: 0000-0003-0824-1848

E.S. Brinyuk

Burdenko Neurosurgical Center

ORCID: 0000-0002-0346-8018

S.V. Kaprovoy

Burdenko Neurosurgical Center

ORCID: 0000-0001-8813-2793

A.G. Nazarenko

Burdenko Neurosurgical Center

ORCID: 0000-0003-1314-2887

Yu.V. Strunina

Burdenko Neurosurgical Center

ORCID: 0000-0003-1696-4050

B.A. Zakirov

Burdenko Neurosurgical Center

ORCID: 0000-0002-8782-850X

M.O. Kudymets

Burdenko Neurosurgical Center

ORCID: 0000-0003-3791-8619

I.A. Stepanov

Irkutsk State Medical University

ORCID: 0000-0001-9039-9147

Received:

31.01.2022

Accepted:

24.03.2023

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