Efficacy of decompressive laminectomy and fenestration for short-segment degenerative lumbar scoliosis combined with spinal stenosis
Objective To compare the clinical efficacy of decompressive laminectomy and fenestration and posterior lumbar in-terbody fusion(PLIF)in the treatment of short-segment lumbar scoliosis with concurrent spinal stenosis.Methods A retro-spective analysis was conducted on 95 cases of short-segment lumbar scoliosis with concurrent spinal stenosis treated between April 2017 and October 2022.Forty-six cases underwent decompressive laminectomy and fenestration(observation group),while 49 cases underwent PLIF(control group).Surgical duration,intraoperative blood loss,bed rest time,length of hospital stay,occurrence of complications,as well as Cobb angle,JOA score,pain VAS score,and ODI index were compared between the two groups.Results All patients were followed up for 11 to 32 months,with a mean 21.3 months.The observation group had significantly shorter surgical duration,less intraoperative blood loss,shorter bed rest time,and shorter hospital stay compared to the control group(P＜0.05).There were no significant differences in JOA scores at 1 day postoperatively,2 months postopera-tively,and final follow-up between the two groups(P＞0.05).There were no significant differences in pain VAS scores at 2 months postoperatively and final follow-up between the two groups(P＞0.05);however,the observation group had significantly lower pain VAS scores at 1 day postoperatively compared to the control group(P＜0.05).There were no significant differences in ODI index at 2 months postoperatively and final follow-up between the two groups(P＞0.05).Cobb angles at 1 day postoperatively and 2 months postoperatively were significantly improved compared to preoperative values in both groups(P＜0.05);however,the observation group showed a significant increase in Cobb angle at final follow-up compared to preoperative values(P＜0.05).There were no significant differences in the incidence of complications between the two groups(P＞0.05).Conclusion decom-pressive laminectomy and fenestration for the treatment of short-segment lumbar scoliosis with concurrent spinal stenosis is as-sociated with shorter surgical duration,less intraoperative blood loss,significant clinical efficacy,and a lower incidence of postoperative complications.However,the degree of scoliotic angle improvement is slightly inferior to that of fusion surgery.Preoperative comprehensive assessment is recommended for elderly patients before considering decompressive laminectomy and fenestration.
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