LUMBAR LAMINECTOMY ALONE VERSUS LUMBAR LAMINECTOMY WITH DYNAMIC STABILIZATION FOR DEGENERATIVE LUMBAR STENOSIS IN ELDERLY PATIENTS

Abstract

Study design. A retrospective study design

Objective. To comprehensively compare the 2-year clinical outcome of lumbar laminectomy alone versus lumbar laminetomy supplemented with dynamic stabilization (Dynesys system) in degenerative lumbar stenosis in elderly patients.

Material and Methods. A total of 60 elderly patients with an average age of 65.1 years (range, 50 to 78 yrs) affected by lumbar stenosis that underwent lumbar laminectomy alone (30 cases) or lumbar laminectomy with supplementary Dynesys system (30 cases) at our Department were sorted and matched according to three criteria : similar patient age, similar degenerative lumbar desease, and identical operative methods (i.e. levels of laminectomy). Patients were compared according to Oswestry Disability Index (ODI), Roland Morris, SF-36 and VAS outcomes scores.

Results. The two cohorts were well matched at 2-years follow-up. Patients treated with lumbar laminectomy alone presented reduced operative time and intraoperative blood loss and reduced postoperative complications, with better clinical outcome compared with patients that received laminectomy with supplementary Dynesys system, for ODI score (28.9 vs 31), Roland Morris (8.25 vs 9.1) and VAS scores (leg pain 36 vs 44.3; back pain 31 vs 38.7), while SF-36 scores resulted similar in both groups of patients.

Conclusions. In degenerative lumbar stenosis, supplementary dynamic stabilization in addition to decompressive laminectomy did not presented significant advantages, with respect to functional outcome, in comparison to lumbar laminectomy alone.