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Surgical Treatment for Degenerative Lumbar Spinal Stenosis, Experience at Cartagena Colombia

Introduction The primary objective of the surgical treatment is to relieve patient's symptoms, reduce the disability, correct deformities, stabilize the column, diminish the fixed segments, protect neurological organs, and decrease rehabilitation time in patients where conservative treatment had failed. Aims: This study aims to compare the percentage of functional limitation and pain intensity in the presurgical and postsurgical period in patients with lumbar spinal stenosis with surgical treatment with decompressive laminectomy, transpedicular instrumentation, and arthrodesis, by the column surgery team in the Universidad de Cartagena in three hospitals in Cartagena city, Colombia between January 2008 and January 2013. Methods Descriptive, comparative longitudinal study of 30 records of patients with clinical and immunological diagnosis, where the Oswestry Disability Index and Visual Analogue Scale were applied in the presurgical and 3 months' postsurgical treatments. Results The most of the patients had canal defects in two or more levels (69.9%), mainly between L4–L5 (28 of 30 patients). Most of the patients needed instrumentation of two or more levels (79.9%). There were intrasurgical complications in three patients (13.3%), all were dural tears; it was only one case of fistula as postsurgical complication (3.3%). About postsurgical results, it was observed a median difference of visual analog scale between presurgical and postsurgical of 5.1 points, and the difference in the median and standard deviation. In the pre- and postsurgical Oswestry Disability Index of 33.3%, which indicates, in our study, all of the patients submitted to surgical treatment by this technique had relevant postsurgical clinical relevance according to the FDA definition (≥ 15% in the Oswestry Disability Index) during a postsurgical following of 18.6 + 11.8 months. Conclusion The decompressive laminectomy technique, transpedicular instrumentation, and arthrodesis was effective to accomplish a clinical relevant benefit in patients with degenerative lumbar spinal stenosis.