Early Outcome of Spinal Decompression for Canal Stenosis at National Orthopaedic Hospital Enugu

Abstract

Background: Spinal canal stenosis occurs most commonly in the lumbar region. The commonest etiology is degeneration disease of the spine. Spinal decompression is the treatment of choice with very good outcome with improved quality of life.

Objectives: The objective is to evaluate the early outcome of decompression surgery for spinal stenosis without spinal instrumentations.

Materials and Method: This is a retrospective study at National Orthopedic Hospital Enugu. Fifty patients who fulfilled the inclusion criteria were selected. Patients requiring instrumentation were excluded. Clinical diagnosis was based on history and physical examination and confirmed by magnetic resonance imaging (MRI) scan or computed tomographic (CT) scan. The following indices viz biodata, symptomatology and pain visual analogue scale scores were extracted and analysed. Follow up was for 6 months. The pain visual analogue scale was used to assess the early outcome.

Results: Fifty six case notes were retrieved but six had incomplete records or lost to follow up. The reviewed 50 patients comprised 26 males and 24 females with male to female ratio of 1.1:1. Their median age was 45years. The commonest presenting compliant was low back pain 35 (70%) patients. The commonest indication for surgery was degenerative spinal disease 43 (86%) patients. About 42 patients (84%) had the compression in the lumbar region. Forty one patients (41%) had posterior decompression. External rigid support was necessary in about 24 patients (48%). Eleven patients (22%) had superficial surgical site infection amenable to few days of wound dressings. About 43 patients (86%) had improvement in their preoperative symptoms VAS while 7 (14%) had either no or worsened VAS.

Conclusion: Spinal stenosis is not uncommon in our locality. Decompression without instrumentations in well selected patients gives good symptomatic and functional outcomes with no significant postoperative complication.