Outcomes of Posterior Decompression and Fusion with and without Instrumentation for Lumbar Spinal Stenosis with Deformity: an Inner City Teaching Institution Retrospective Study

55 consecutive patients of the same surgeon and same institution with lumbar spinal stenosis and spine deformity (spondylolisthesis. retrolisthesis, scoliosis) treated surgically with both decompression and fusion were retrospectively reviewed for the affect of instrumentation on surgical and clinical results. Group I consisted of 33 patients (18 male, 15 female) with a mean age of 53.4 years, all of whom had pedicle screw fixation as an adjunct to their fusions. Group II consisted of 22 patients (11 male, 11 female) with a mean age of 62.3 years, and had no internal fixation along with their fusions. Minimum follow–up was 24 months with a mean of 40.4 +/– 14.1 months for Group I and a mean of 33.6 +/– 8.2 months for Group II. All patients had failed a minimum of six months of non–operative treatment (physical therapy, NSAID'S, epidural steroids), with a mean time to surgical intervention of 9.1 months. Medical comorbidities averaged 1.1 for Group I and 1.3 for Group II. Evidence of arthrodesis or pseudoarthrosis was graded blindly by an independent bone radiologist. Patient satisfaction for both preoperative and postoperative leg pain as well as back pain was graded via visual analog scale. Statistical analysis was via Student's t–test. Group I had a mean improvement in leg pain postoperatively of 52.3% (8.8 to 4.2, p <0 .05), and a mean improvement in back pain of 47.8% (9.0 to 4.7, p < 0.05). The pseudoarthrosis rate Group I was 15.2% (5/33). II had leg postoperatively 67.1% (7.9 2.6, 0.05), 59.2% (8.1 3.3, 22.7% (5/22). Complications were 24% included 2 wound seromas, deep infections, dural tears, one transient nerve root deficit 1 failed hardware. 14% tears infection. age statistically younger (p 0.05) than II. There correlation between less satisfactory results (p<0.05), but not no Workman's Compensation status. correlations comorbidities, including smoking, or unsatisfactory result rates. Instrumentation improved fusion patients undergoing decompression for spinal stenosis with deformity, statistical affect on clinical results. trend towards higher complication the instrumented group, especially regards complications.

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