Management of lumbar canal stenosis should be started with conservative treatment and preferably with a multimodal approach, but in cases of severe pain with extensive neurogenic claudication symptoms, surgical intervention is indicated. This retrospective study targets to evaluate the outcome of classic laminectomy surgery alone versus laminectomy with fixation surgery in patients with lumbar canal stenosis regarding improvement of pain and function. Data of 184 patients of the study groups were divided into group A (data from patients who underwent laminectomy and foraminotomy only) and group B (data from patients who underwent laminectomy and foraminotomy with spinal fixation). Preoperative, operative, postoperative (PO), and follow-up data were extracted and analyzed from files of patients fulfilling the inclusion criteria. Primary outcome was at least 50% improvement of pain severity regarding numeric rating scale (NRS) and Oswestry disability index (ODI) score at 6-months PO compared to preoperative scores. Operative time was significantly longer in group B than group A. Immediate PO data regarding PO analgesic requirement, amount of wound drainage, and PO hospital stay showed non-significant difference between both groups. There was a statically significant improvement of EHL muscle strength regarding Odom’s scoring in group B in which the success rate for pain improvement was 81.8% and for disability was 66.8%. There were insignificant differences in patient’s satisfaction to surgery with variable ages, a significant outcome in females and in patients with fewer levels of affection of both groups. The present study reported the efficacy and safety of the laminectomy, foraminotomy, discectomy, and medial facetectomy with spinal fixation using trans-pedicular screws for management of patients with spinal canal stenosis.

中文翻译：

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评估单纯椎板切除术与椎板切除术加固定术治疗腰椎管狭窄症患者的疼痛和功能改善情况

腰椎管狭窄症的治疗应从保守治疗开始，最好采用多模式方法，但如果出现剧烈疼痛并伴有广泛的神经源性severe行症状，则应进行手术干预。这项回顾性研究旨在评估腰椎管狭窄症患者在疼痛和功能改善方面单独进行经典椎板切除术与椎板切除术与固定术的疗效。研究组的184例患者的数据分为A组（仅接受椎板切除术和开孔术的患者数据）和B组（来自椎板切除术和经椎弓钉固定术的患者数据）。从符合纳入标准的患者档案中提取和分析术前，术中，术后（PO）和随访数据。与手术前的评分相比，主要结果是在6个月的PO时，数字评分量表（NRS）和Oswestry残疾指数（ODI）评分的疼痛严重程度至少提高了50％。B组的手术时间明显长于A组。关于PO镇痛要求，伤口引流量和PO住院时间的即时PO数据显示，两组之间无显着差异。B组的Odom评分显示，EHL肌肉力量在静态上有显着改善，其中疼痛改善的成功率为81.8％，残疾改善的成功率为66.8％。年龄可变的患者对手术的满意度无显着差异，女性和两组患病率较低的患者的结局均显着。