Assessment of Functional Outcome and Complications in the Surgical Decompression of Lumbar Spinal Stenosis: A Systematic Review

Abstract

Background: Surgical intervention may become necessary for chronic pain secondary to Lumbar Spinal Stenosis (LSS). It can be effectively achieved by using Conventional Decompression Surgery (CDS) or Minimally Invasive Spine Surgery (MISS). This study aimed to compare the functional outcome and complications associated with these two techniques. Methods: Online database sources (PMC and Cochrane Library) were utilized to identify 1,050 publications, which were narrowed down to 18 studies included in this systematic review. The mean postoperative improvement in Oswestry Disability Index (ODI) and Visual Analog Scale/ Numeric Pain Rating Scale (VAS/NPRS) scores was statistically evaluated by using SPSS-23 and compared for the two techniques through independent t-test. A p-value <0.05 was considered significant. Results: A total of 1,724 patients [CDS=705; MISS=1019] were included in the study. MISS cases had a significantly greater mean ODI preoperatively and the mean ODI improvement was significantly better in this cohort. The patients undergoing MISS also had a significant decline in the VAS/NPRS scores for Low Back Pain (LBP) and Leg Pain (LP). A significantly higher rate of operative complications and reoperation were seen in CDS patients. Conclusion: In cases of LSS, this review suggests that MISS carries a lower risk of complications and appears to yield better functional outcomes when compared to CDS.