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Clinical outcomes of microscopic decompression for degenerative lumbar foraminal stenosis: a comparison between patients with and without degenerative lumbar scoliosis
Authors:Kentaro Yamada  Hideki Matsuda  Masaharu Nabeta  Hiroshi Habunaga  Akinobu Suzuki  Hiroaki Nakamura
Affiliation:(1) Department of Orthopaedic Surgery, Ishikiriseiki Hospital, 18-28, Yayoi-cho, Higashiosaka, Osaka, Japan;(2) Department of Orthopaedic Surgery, Ikeda Hospital, Higashiosaka, Japan;(3) Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan;(4) Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, Japan
Abstract:We performed microscopic lumbar foraminotomy in all the patients diagnosed with degenerative lumbar foraminal stenosis (DLFS) and retrospectively reviewed the clinical outcomes and the factors influencing them. The preoperative Japanese Orthopaedic Association (JOA) score of 13.8 significantly improved to 21.9 postoperatively. Although leg pain reduced in 44 patients (95.7%) immediately after surgery, it recurred in 9 patients (19.6%). The recurrence frequency was significantly higher and the JOA score improvement ratios significantly lower in patients with degenerative lumbar scoliosis (DLS) than in those without DLS. Even among patients with DLS, those with <3° Cobb angle difference between the supine and standing positions showed satisfactory results, with no recurrence. In conclusion, microscopic lumbar foraminotomy for DLFS produced satisfactory clinical outcomes even in patients with DLS. However, the outcomes were poor in patients with unstable DLS.
Keywords:Degenerative lumbar scoliosis   Foraminal stenosis   Microsurgical decompression   Less-invasive surgery
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