2023 Volume 14 Issue 6 Pages 966-972
Introduction: In this study, changes in low back pain after posterior decompression surgery without spinal fusion for lumbar spinal canal stenosis in patients who presented primarily with low back pain were investigated.
Methods: The study included 51 patients who presented primarily for evaluation of low back pain and underwent microscopic posterior decompression surgery without spinal fusion for lumbar spinal canal stenosis. Preoperative and postoperative low back pain, leg pain, lower extremity numbness, Japanese Orthopaedic Association back pain evaluation questionnaire (JOABPEQ) scores, lumbar kyphosis angle and range of motion, intervertebral joint edema, vertebral end plate Modic changes, spinous process kissing, and vertebral body slippage were recorded. Low back pain visual analog scale (VAS) scores were compared between patients who improved (improvement group) and those without improvement (non-improvement group).
Results: Low back pain improved in 72.5% of the patients. The preoperative low back pain VAS and postoperative JOABPEQ severity scores associated with pain-induced disability, gait dysfunction, social disability, psychological disability, and preoperative lumbar spine range of motion were significantly greater and Modic changes were significantly fewer in the improvement group.
Conclusions: The present suggest that patients with high levels of preoperative low back pain and a low degree of lumbar vertebral body endplate injury show improvement in low back pain after the aforementioned surgery. In contrast, patients with vertebral endplate lesions may experience residual low back pain, and additional treatment such as spinal fusion should be considered in such cases.
