Outcomes of Posterior Decompression and Spinal Instrumentation in the Treatment of Lumbar Canal Stenosis

Abstract

Background: Lumbar canal stenosis (LCS) is a common degenerative spinal condition causing neural compression, leading to pain, functional impairment, and reduced quality of life. While posterior decompression is the gold-standard surgical approach, its combination with spinal instrumentation provides additional stability in cases with potential postoperative instability.

Aim: To evaluate the outcomes of posterior decompression and spinal instrumentation in patients with lumbar canal stenosis, focusing on functional improvement, pain relief, complications, and overall effectiveness.

Methods: This prospective study included 42 patients with lumbar canal stenosis treated with posterior decompression and spinal instrumentation at SCB Medical College, Cuttack, from February 2024 to January 2025. Preoperative and postoperative functional outcomes were assessed using the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) for pain. Data on complications and patient satisfaction were also recorded. Statistical analysis was performed using SPSS version 23.0, with significance set at p < 0.05.

Results: The mean preoperative ODI of 75.3% improved significantly to 25.4% at 12 months postoperatively (p < 0.001). Pain scores also demonstrated substantial improvement, with mean VAS scores decreasing from 6.8 at 1 month to 1.8 at 12 months. Minor complications, such as superficial infections, occurred in 3 patients (7.1%), with no major complications reported. Overall, 90.5% of patients experienced complete pain relief, and functional outcomes improved consistently over follow-up.

Conclusion: Posterior decompression with spinal instrumentation is an effective and safe intervention for lumbar canal stenosis, significantly improving functional outcomes and providing substantial pain relief with minimal complications. The procedure demonstrates high patient satisfaction and long-term efficacy.

Recommendations: Future research should explore the comparative effectiveness of this technique versus emerging motion-preserving surgical approaches, particularly in younger patients. Additionally, studies focusing on cost-effectiveness and the prevention of adjacent segment disease are warranted.

Keywords: Lumbar canal stenosis, posterior decompression, spinal instrumentation, functional outcomes, surgical complications