ABSTRACT

Spinal stenosis is narrowing of the spinal canal, nerve root canals and neural foramens. Nar-rowing can be caused by bone or soft tissue structures or both. Low back pain, neural claudi-cation and neural deficits can be seen clinicaly. In treatment, generally non operative treatments prefferred. Patients that have limited walking abilities as a result of neural claudication and the ones that do not respond to medications are candidates for surgery. In this research, we have evaluated the clinical results of 48 patients, mean age 61.4 ± 9.9 having degenerative lum-bar spinal stenosis and applied wide decomp-ression, postero-lateral fusion and 3rd generati-on spinal instrumentation. We have set this ret-rospective cohort study up to determine the time between surgery and onset of the symptoms and also to clarify the relation between the cor-rection of the sagittal curve and the clinical out- comes. Apart from the clinical assesment, we have used computerized tomography, magnetic resonance imaging modalities to ensure our di-agnosis. The research group is composed of the patients that were at least one year on medicati-ons and had at least one set of physiotherapy. On clinical evaluation we have used Oswestry Disability Index (ODI) and SRS-22 (Scoliosis Research Society) çuestionnaire. When we inc-lude all the patients we have found that the pre-operative ODI scores 34,3 ± 14,4 significantly increased to 54,8 ± 4,4 post-operatively (p<0,05). Pre-operative SRS-22 scores, for do-mains pain, function, mental health, self image, and satisfaction with management mean scores were2.9± 1.1, 3.0± 0.7, 3.5± 1.1, 3.4 ± 1.2and 2.7 ±1.3 respectively and the total score was 3.1 ± 1.1 and post operatively all the domains in all patients significantly raised to 4 and plus credits (p<0,05). At the last follow up when we include all the patients ODI scores decreased to mean 53.4 ± 5.5, and for the SRS-22 çuestionnaire we have minimal reductions. No patients do have any neural claudication, and their walking distan-ces increased significantly. Apart from one pati-ent all the others had had solid fusions. Accor-ding to Pearson’s correlation tests the clinical outcomes are disproportionate to the time inter-val for the symptoms to occur and proportionate with the correction of the sagittal curves. In this research, we concluded that with surgical indica-tions, wide decompression, postero-lateral fusi-on and 3rd generation posterior instrumentation leads to satisfactory results. In the light of these data to perform early surgical procedures and use of instrumentation for the correction of sagittal curves affect the clinical outcomes positively.