Abstract:

BACKGROUND: Degenerative lumbar spinal stenosis could be treated by laminectomy internal fixation placement, unilateral or bilateral decompression, posterior laminectomy and so on. However, whether laminectomy internal fixation placement can be used remains unclear.
OBJECTIVE: To evaluate the efficacy of interbody fusion cage implantation of pedicle screw fixation, in combination with posterior lumbar laminectomy, bilateral resection and decompression of the inferior articular process, autologous facet joint bone transplantation in the treatment of degenerative lumbar spinal stenosis.
METHODS: A total of 41 patients of degenerative lumbar spinal stenosis, who failed after 3 months of conservative therapy, including 23 males and 18 females, at a mean of 60.3 years, received posterior lumbar laminectomy, bilateral inferior articular process resection and decompression, autologous facet joint bone and cage interbody fusion implant pedicle fixation. They were followed up for 24 months, preoperative and postoperative Japanese Orthopedic Association (JOA) score evaluations were performed to assess the therapeutic efficacy of the patients, radiological examination was done to investigate the graft fusion and vertebral stability of surgical segments in patients.
RESULTS AND CONCLUSION: During the follow-up, JOA score significantly increased compared with the preoperative score  (P < 0.01) and clinical excellence rate was 90%; 40 cases obtained bony fusion, with a fusion rate of 98%, 1 patient exhibited signs of lumbar instability. There was no loosening, fracture and other complications after internal fixation, but 2 cases appeared dural tear, 1 case pedicle position deviation, 1 case pseudoarticulation formation. The results suggest that the posterior lumbar laminectomy, bilateral inferior articular process resection and decompression, autogenous facet joint bone and cage interbody fusion implanted pedicle screw fixation show good clinical effects for the treatment of degenerative lumbar spinal stenosis.