ArticleSpine surgery and related research2017
Indications for prophylactic lumbar decompression at the L3/4 level in patients with L4/5 responsible lumbar spinal canal stenosis.
Article in Spine surgery and related research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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5 authors.
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Abstract
introductionLumbar spinal canal stenosis (LSS) is a very common disease. When the responsible level is considered to be L4/5 despite the appearance of double-level (L3/4 and L4/5) stenosis on magnetic resonance imaging (MRI), it is difficult for spinal surgeons to decide whether prophylactic decompression should be performed at the L3/4 level. The purpose of this study was to investigate the relationship between the dural sac cross-sectional area (DCSA) at the L3/4 level and clinical symptoms in patients with double-level stenosis.
methodsThirty-five patients with double-level stenosis were registered in this study. All patients underwent decompression surgery at the L4/5 responsible level. The severity of patients' symptoms was evaluated by the Japanese Orthopaedic Association (JOA) score and its rate of recovery. A measurement program on MRI was used to determine the DCSA.
resultsThe clinical course of LSS according to the JOA score recovery rate at the final follow-up revealed that the good group (≥50%) included 27 patients, and the poor group (<50%) included 8 patients. In the good group, the mean DCSA at the L3/4 level was 72.3 ± 32.1 mm
conclusionsConsidering the present results, prophylactic decompression surgery at the L3/4 level should be performed for patients with double-level stenosis and DCSA <50 mm
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