• T J Kleeman, A C Hiscoe, and E E Berg.
• New Hampshire Spine Institute, Bedford, NH 03110, USA. tkleeman@pol.net
• Spine. 2000 Apr 1; 25 (7): 865-70.

Study DesignA prospective evaluation of the outcome of a decompressive procedure for lumbar spinal stenosis designed to preserve spinal stability.ObjectivesTo determine whether decompression could be achieved without subsequent fusion for spinal stenosis with and without degenerative spondylolisthesis.Summary Of Background DataThe traditional surgical decompression of spinal stenosis involves removal of the posterior elements. Success occurs in 64% of cases, on the average, with results deteriorating over time. Concomitant spinal fusion is associated with higher costs and complication rates.MethodsThis prospective study included 54 consecutive patients treated surgically by one surgeon. Patients were contacted 21/2 and 4 years, on the average, after surgery. Patients with spondylolisthesis were evaluated for worsening of the listhesis after surgery.ResultsAt a mean of 4 years after surgery, all patients were satisfied with their treatment. Concerning their symptoms, 80% reported relief of back pain; 96% had improvement of leg pain; 93% experienced relief of leg numbness; and 97% had relief of lower extremity weakness. Before surgery, only 1 patient could walk for longer than 15 minutes. After surgery, 98% (47/48) could walk for more than 15 minutes. Overall clinical results were graded as good to excellent (88%), fair (8%), or poor (4%). Clinical outcomes were comparable between those with and without degenerative spondylolisthesis (P = 0.08). Patients with degenerative spondylolisthesis showed no change in the amount of slip in 13/15 patients (87%).ConclusionsDegenerative spinal stenosis, even with nonlytic spondylolisthesis, can be decompressed effectively without violating the integrity of the posterior elements.

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