요추 협착증에서 미세수술적 감압술과 기구고정술을 병행한 요추간 골유합술과의 임상적 비교

Abstract

Objective：We report clinical results of the patients who received microsurgical decompression procedure(bilateral partial laminectomy and medial facetectomy：Group A) compared with lumbar interbody fusion with instrumentation(total laminectomy, interbody fusion and pedicle screw fixation：Group B). Methods：From March 1996 to December 2000, twenty patients with symptomatic lumbar stenosis underwent microsurgical decompression and twenty-five patients underwent lumbar interbody fusion by two operators. Two groups of patients were compared retrospectively in respect to the mechanical back pain, leg pain, motor weakness, sensory hypesthesia(numbness) and clinical outcomes. The mean follow-up period was 30 months. Results：In Group A, mechanical back pain, leg pain, motor weakness, and sensory hypesthesia were improved in 72.2%, 69%, 80%, 44.4% and 70%, 71%, 83.3%, 50% respectively in Group B. Clinical outcomes was excellent or good in 80% in Group A and 84% in Group B and no differences in clinical parameters between Groups were demonstrated. Conclusion：We recommend microsurgical decompression for the patients suffering from symptomatic lumbar stenosis with stable spine because microsurgical decompression provided a satisfactory clinical results equivalent to lumbar interbody fusion with instrumentation.