Functional outcome of instrumented and non-instrumented fusion in lumbar canal stenosis

Authors

  • Ansari Muqtadeer Abdul Aziz Department of Orthopaedics, Government Medical College and Hospital, Aurangabad, Maharashtra, India
  • Nair Pradeepkumar Sasidharan Department of Orthopaedics, Government Medical College and Hospital, Aurangabad, Maharashtra, India
  • Ansari Ishtyaque Abdul Aziz Department of Neurosurgery, MGM Medical College, Aurangabad, Maharashtra, India
  • Venktesh Dattatray Sonkawade Department of Orthopaedics, Government Medical College and Hospital, Aurangabad, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20203518

Keywords:

Lumbar canal stenosis, Modified Oswestry disability index, Instrumented lumbar fusion

Abstract

Background: Lumbar canal stenosis (LSS) is a source of significant morbidity and economic burden in the Indian population. Spinal canal compression is the sine qua non of lumbar canal stenosis but whether instrumentation should be done or not is the major dilemma. In this study, we aim to compare the functional outcome of instrumented versus non-instrumented fusions for the treatment of lumbar stenosis along with the post-operative complications and cost-effectiveness of both procedures.

Methods: This study was conducted at a tertiary-care medical college and hospital, Aurangabad specializing in post-graduate training, where all patients who underwent surgical treatment between May 2016 and May 2018 were included. Patients were assessed using the modified Oswestry disability index (MODI) and visual analogue scale (VAS). These evaluations were done at 3, 6, 12 and 24 months.

Results: We found similar pain relief and stabilization in both the groups in the initial post-operative period, but after 2 years, there was a significant difference (p=0.0001) between the two groups in terms of VAS (back) and MODI score. Complication rate was higher in instrumented patients. 

Conclusions: Patient selection is the most important thing in the management of lumbar canal stenosis. We believe that, with the flowchart on the management of lumbar canal stenosis, it would help choosing patients better as to who would require instrumented fusion. Non-instrumented fusions might cost less and have fewer complications, but the overall outcome of the patient in the future should be kept in mind.

Author Biographies

Ansari Muqtadeer Abdul Aziz, Department of Orthopaedics, Government Medical College and Hospital, Aurangabad, Maharashtra, India

Orthopaedics

Nair Pradeepkumar Sasidharan, Department of Orthopaedics, Government Medical College and Hospital, Aurangabad, Maharashtra, India

Orthopaedics

Ansari Ishtyaque Abdul Aziz, Department of Neurosurgery, MGM Medical College, Aurangabad, Maharashtra, India

Neurosurgery

Venktesh Dattatray Sonkawade, Department of Orthopaedics, Government Medical College and Hospital, Aurangabad, Maharashtra, India

Orthopaedics

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Published

2020-08-26

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Original Research Articles