Lumbar canal stenosis in “young” - How does it differ from that in “old” - An analysis of 116 surgically treated cases

Abstract

Objective: Patients treated for lumbar canal stenosis (LCS) were retrospectively analyzed to evaluate the differences in clinical management in those below (Group A) and those above (Group B) the age of 50 years. All patients were treated with the premise that instability is the nodal point of the pathogenesis of LCS and “only-stabilization” is the surgical treatment. Materials and Methods: During the period June 2014 to June 2020, 116 cases were diagnosed to have LCS and surgically treated by the Goel modification of Camille's transarticular screw fixation technique. Results: Twenty-four patients in Group A and six patients in Group B had a history of “significant” injury to the back at the onset of clinical symptoms. The indices suggested that the intensity of symptoms was relatively more severe in Group A than in Group B. Unilateral leg symptoms were more common in Group A (68%) than in Group B (31.8%). Neurological motor deficits were more common in Group A (28%) than in Group B (12%) patients. Spinal segments surgically treated in Group A ranged from 1 to 4 (average 2 levels) and in Group B it ranged from 2 to 5 (average 3 levels). During the follow-up period that ranged from 6 to 72 months (average 37 months), 100% of patients had varying degrees of relief from symptoms. Conclusions: LCS is confined to a lesser number of spinal segments in the Group A patients. The symptoms were radicular in nature and relatively severe in Group A than in Group B patients.

“Only fixation” in cases with failed decompression for lumbar canal stenosis – Analysis of outcome in 14 cases

“…[ 6 ] We recently reported our experience of treating cases with lumbar canal stenosis with only fixation using Camille’s technique of transarticular fixation. [ 8 , 12 13 14 15 16 ] Both our techniques identified the role of stabilization and futility of decompression in the surgical treatment. On the basis of our observations, we preferred the nomenclature of lumbar spinal “instability” to lumbar canal “stenosis.”[ 17 ] We identified similar surgical philosophy of “only fixation” ideal for radiculopathy or myelopathy related single or multiple level cervical spinal degeneration.…”