Internal Decompression for Lumbar Spinal Stenosis—Indications, Technic, Results

Introduction The laminectomy, that is, the complete removal of the posterior wall of spinal canal, thus termed as external decompression, has been employed as traditional surgical method for lumbar spinal stenosis. The concept of unilateral laminotomy with bilateral decompression of the spinal canal based on thinning of the internal osseous surface of posterior canal wall instead of its removal was termed internal decompression. The success rate of decompression for lumbar spinal stenosis ranges from 57 to 95%.

Aim We present a prospective study investigating effectiveness of microsurgical internal decompression for lumbar spinal stenosis and assessed the factors affecting the outcome.

Material and Methods A total of 126 consecutive patients underwent internal decompression for multilevel lumbar spinal stenosis. They were divided into three age groups (60 < , 60–75, >75 years). Neurological and pain outcome were assessed using Mc Gill-Melzack Pain Questionnaire, ASIA score, and Neurogenic Claudication Outcome Score. The follow-up period was 6 to 58 months.

Results The favorable initial result was achieved in all operated patients, while long-term positive result was observed in 85% of patients.

Conclusion Microsurgical internal decompression combines high effectiveness and minimal traumatization with preservation of spinal stability. Predictors of good outcomes were neurogenic claudication, severe constriction on imaging, and younger age.