The importance of the conservative surgical enlargement in the treatment of lumbar spinal canal stenosis without fusion

Authors

  • Mohammed Ali

Abstract

This study included 40 patients suffering from the lumbar spinal canal stenosis without a spondylolysthesis. including 25 female and 15 male aged between 40 and 75 years, and has been proven diagnosis clinically and by  magnetic resonance and / or CT.

The Patients were treated with surgery by expanding the exits of the nerve roots and the eradication of bony beaks and yellow oversized ligamentum flavum without complete laminectomy and without affecting the stability of the spine.

The main problem was patients are having a sensory symptoms (numbness and ants) in the lower limbs, and also low back pain in all patients, and intermittent claudication, which ranged presence of 45% for a distance of less than 20 m to 27.5% for a distance of 20-50 meters and also 27.5% of the distance 50-100 m.

The patients showed improvement postoperatively as follows: After one month showing improved sensory symptoms (numbness and ants) when 42% of the patients and the  improves lower back at 10%, and improve intermittent claudication distance since I arrived in 50-100m distance of up to 65%.

But after a year of treatment was the proportion of clear improvement which reached the sensory symptoms improved ratio of up to 95%, while the low back pain has improved at 85%, and intermittent claudication distance amounted to 87.5% for a distance of more than 100 m.

This result emphasizes the importance of expanding the spinal canal conservative without mischief paragraphs stability and thus without having to arthrodesis. vertebrae and confirm its usefulness in improving the clinical condition of the patient.

أهمية التوسيع الجراحي المحافظ في علاج تضيق
القناة الشوكية القطنية دون اللجوء إلى إيثاق الفقرات

شملت هذه الدراسة 40 مريض يعانون من تضيق القناة الشوكية القطنية دون وجود انزلاق فقري شديد ، منهم 25 أنثى و 15 ذكر تراوحت أعمارهم بين 40 و 75 سنة ،  تم إثبات التشخيص سريريا و شعاعيا (رنين مغناطيسي و/أو طبقي محوري).

العلاج الجراحي المتبع : توسيع مخارج الجذور العصبية و استئصال المناقير العظمية و الرباط الأصفر المتضخم دون الاضطرار إلى استئصال الصفيحة الفقرية كاملة ، و في بعض الحالات خزع جزء من الصفيحة الضاغط على البنى العصبية دون التأثير على ثباتية العمود الفقري .

كانت المشكلة الرئيسية عند المرضى هي وجود الأعراض الحسية (الخدر و النمل ) في الطرفين السفليين و الام أسفل الظهر عند جميع المرضى ،  و العرج المتقطع الذي تراوح وجوده من45% لمسافة اقل من 20م  إلى 27.5 % لمسافة 20-50 م و 27.5% لمسافة 50-100 م .

الأعراض الحسية (الخدر و النمل ) تحسنت بعد شهر عند 42% من المرضى ،الام الظهر عند 10% من المرضى, و أما مسافة العرج المتقطع وصلت لمسافة 50-100 م عند 65 % .

تحسنت الاعراض الحسية بعد سنة حتى 95% و الام اسفل الظهر وصل إلى 85% و مسافة العرج المتقطع وصل 87,5% لمسافة أكثر من 100 م .

الخلاصة :

إن توسيع القناة الشوكية المحافظ دون اذية ثباتية الفقرات و بالتالي دون الحاجة إلى إيثاق فقرات ذو فائدة في تحسن الحالة السريرية للمريض.

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Published

2018-09-26

How to Cite

1.
Ali M. The importance of the conservative surgical enlargement in the treatment of lumbar spinal canal stenosis without fusion. Tuj-hlth [Internet]. 2018Sep.26 [cited 2024Nov.24];39(4). Available from: https://journal.tishreen.edu.sy/index.php/hlthscnc/article/view/3969

Issue

Vol. 39 No. 4 (2017): العلوم الصحية

Section

Articles

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