Functional Outcome after Posterior Decompression and Instrumented Fusion in Lumbar Spinal Stenosis

Open Access

Abstract

Background: Lumbar spinal stenosis (LSS) is a common degenerative disorder characterized by narrowing of the lumbar spinal canal and neural foramina, leading to neurogenic claudication, radiculopathy, and functional disability. Surgical intervention is indicated when conservative management fails or neurological deficits progress. Aim of the study: This study aimed to evaluate the functional outcomes, patient satisfaction, and complication profile following posterior decompression with instrumented fusion in patients with symptomatic LSS. Methods & Materials: A prospective observational study was conducted at the Department of Orthopedic Surgery, Bangladesh Medical University, Dhaka, Bangladesh from January 2024 to December 2024, enrolling 38 adult patients with MRI-confirmed LSS. All participants underwent posterior decompression and pedicle screw–based instrumented fusion. Baseline demographic and clinical data were recorded. Functional outcomes were assessed preoperatively and at 3 months postoperatively using the Oswestry Disability Index (ODI) and Roland–Morris Disability Questionnaire (RMDQ). Clinical success was defined as an ODI reduction ≥15%. Patient satisfaction and postoperative complications, including reoperation, implant-related issues, adjacent segment degeneration, and infection, were documented. Statistical analysis was performed using paired t-tests, with significance set at p<0.05. Results: The mean age was 60.3 ± 11.4 years, with 81.6% female and 63.2% single-level stenosis. Mean ODI decreased significantly from 48.6 ± 12.4 preoperatively to 24.3 ± 10.2 postoperatively (p<0.001), and RMDQ scores improved from 15.2 ± 4.3 to 7.1 ± 3.5 (p<0.001). Clinically successful outcomes were achieved in 63.16% of patients, and 94.74% reported satisfaction. Complications were minimal, with reoperation in 5.26% and other complications ≤2.63%. Conclusion: Posterior decompression with instrumented fusion provides significant functional improvement and high patient satisfaction with an acceptable safety profile, supporting its use in carefully selected LSS patients.