Surgical management of neurogenic claudication in 100 patients with lumbar spinal stenosis due to degenerative spondylolisthesis

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Abstract
100 consecutive patients with neurogenic claudication due to segmental spinal stenosis in degenerative Spondylolisthesis have been analyzed prospectively with respect to their clinical presentation, radiological and intra-operative findings, operative techniques and surgical results. By including 6 patients who had to be operated upon again overall results were excellent in 91, good in 4, satisfactory and moderate in 2, respectively, and poor in 1 patient (mean period of postoperative observation: 2.9 years). Three different techniques of spinal instrumentation are evaluated with respect to the surgical results. After microsurgical decompression of the neural elements 38 patients were fixed using the translaminar screw fixation method according to Magerl (re-operation necessary in 5), in 9 patients spondylodesis was achieved by the plate fixation method according to Louis (re-operation necessary in 1) and in 53 patients (as well as in the 6 patients who had to be re-operated on) primary Cotrel-Dubousset instrumentation was used. The best surgical results were obtained by laminectomy and Cotrel-Dubousset fixation. Instrumentation of more than 1 motion segment was restricted to patients with additional scoliosis or severe degenerative changes of the lumbar spine.