Results of surgical treatment of degenerative stenosis of the lumbar and cervical spine

Objective: To evaluate the results of surgical treatment of degenerative stenosis of the lumbar and cervical spinal canal.

Material and methods: The data on 557 patients with lumbar and cervical disc herniation were analyzed. The study included 219 women (39.3%) and 338 men (60.7%). The patients’ age ranged from 31 to 74 years. Distribution of patients with lumbar disc herniation according to the WHO age criteria was as follows: 155 (27.8%) aged 18–44 years, 237 (42.6%) aged 45–59 years, and 165 (29.6%) aged 60–74 years. The median age was 53.7 years. The patients were divided into two groups: the first group included 290 patients (52.1%) who underwent open microdiscectomy, and the second group included 267 patients (47.9%) who underwent minimally invasive endoscopic discectomy. Each of the above-mentioned groups was further divided into two subgroups: those with monosegmental lesions and those with polysegmental lesions. The comprehensive examination of patients included clinical neurological examination, general and functional spondylography, CT, MRI, and statistical analysis.

Results: Treatment outcomes with endoscopic discectomy, regardless of the extent of the lesion (monosegmental or polysegmental), were statistically significantly better than those with open microdiscectomy. In each of the two comparison groups, treatment outcomes for monosegmental lesions were statistically significantly better than those for polysegmental lesions. Furthermore, in each of the two comparison groups, treatment outcomes worsened progressively during the first year after surgery and improved slightly by the second year. By analyzing these patterns and comparing them with the results of comprehensive clinical data and ancillary studies, we identified a correlation with the development of postoperative instability at these spinal levels.

Conclusion: Treatment outcomes with endoscopic discectomy, regardless of the extent of the lesion (monosegmental or polysegmental), were statistically significantly better than those with open microdiscectomy. In each of the two comparison groups, treatment outcomes for monosegmental lesions were statistically significantly better than those for polysegmental lesions. Furthermore, in each of the two comparison groups, treatment outcomes worsened progressively during the first year after surgery and improved slightly by the second year. By analyzing these patterns and comparing them with the results of comprehensive clinical data and ancillary studies, we identified a correlation with the development of postoperative instability at these spinal levels.

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