Background: Lumbar degenerative spondylolisthesis (DS) is the forward slippage of a superior lumbar vertebra relative to the inferior vertebra due to degeneration, with the pars interarticularis intact. Objective: to study the results of neural decompression in elderly patients with lumbar canal stenosis (LCS) associated with single segment Stable Grade-I Lumbar DS with neurogenic claudication and/or sciatica as main complaint with no or mild low back pain. Patients and Methods: This prospective study included all the elderly patients with LCS associated with single segment stable grade I lumbar DS who were operated upon with neural decompression from November 2011 to November 2014 in the Neurosurgery Department of Benha University Hospital with 12 months postoperative follow up. These patients had failed conservative measures of at least twelve weeks before surgery. Preoperative plain X. ray lumbosacral spine (LSS) was done during functional postures and vertebral stability was studied and preoperative MRI LSS was done. Results: 32 patients were included in this study. Adequate lumbar neural decompression without fusion showed satisfactory rate of improvement ranging from 57% - 81% (Mean ± SD = 72.8 ±6.6) according to the JOA score system for low-back pain. There was no detected clear motion between the two vertebral bodies of the spinal segment showing DS in postoperative dynamics indicating preserved vertebral stability after surgery with minimal complications. Conclusion: Lumbar DS is a degenerative disease results in neural compression but does not result necessarily in vertebral instability, so we recommend that elderly Patients with lumbar canal stenosis associated with single segment Stable Grade-I Lumbar DS with neurogenic claudication and/or sciatica as main complaint with no or mild low back pain to be treated by only neural decompression without fusion as restabilization process have taken place already. |
