TITLE:
Surgical Management of Degenerative Lumbar Spinal Stenosis: Decompressive Laminectomy alone versus Decompressive Laminectomy with Lumbar Arthrodesis: A Malian Experience about 124 Cases
AUTHORS:
Oumar Coulibaly, Kisito Quénum, Mahamadou Dama, Daouda Sissoko, Youssouf Sogoba, Moussa Diallo, Mamadou Salia Diarra, Fatogoma Sangaré, Drissa Kanikomo, Oumar Diallo
KEYWORDS:
Narrow Lumbar Canal, Lumbar CT, Osteosynthesis, Laminectomy
JOURNAL NAME:
World Journal of Neuroscience,
Vol.15 No.3,
August
20,
2025
ABSTRACT: Introduction: Degenerative Lumbar Spinal Stenosis (DLSS) is an acquired spinal disease associated with age and osteoarthritis in more than 95%. It is an osteo-disco-ligamentous conflict located on the nerves of the cauda equina. The aim of our work is to carry out a comparative study in the management of this pathology in our daily practice. Materials and methods: This study was a retrospective review of 124 cases of degenerative lumbar spinal stenosis treated in our department over a period of 09 years. There was 72 men and 52 women. All of our patients have undergone lumbar CT scan. The surgical decision was formally made after failure of medical treatment at least 03 months. Results: The sex ratio was 1.38 M / 1F. The mean age of presentation was 48.56 years with extremes ranging from 28 to 77 years. Farmers were the most affected patients with 40%, followed by housewives and civil servants with respectively 28% and 23%. The mean duration of symptoms before presentation was 15 months with extremes ranging from 06 months to 02 years. The most clinical symptoms were dominated by neurogenic claudication followed by lumbar back pain. Sixty two percent (62%) of our patients underwent lumbar arthrodesis (group 1) and thirty eight (38%) underwent simple laminectomy (group 2). We noted an overall success of 98.70% in group 1 versus 89.36% in group 2 after one year of follow-up. Delayed wound healing, surgical site infection, postoperative fibrosis, insufficient decompression, and adjacent segment syndrome were the main complications encountered in our series. We noted 1 case of death. Conclusion: The degenerative narrow lumbar canal will be a public health problem in several countries, including ours. Especially due to arthritis phenomena, its management must take into account the patient’s age, weight, occupation and also radiological data. Laminectomy with osteosynthesis seems to be better for us, compared to simple laminectomy.