Surgical Management of Lumbar Spinal Canal Stenosis with Instrumentation at the Yaounde Central Hospital: Comparison of Unilateral versus Bilateral Pedicle Screw Fixation Combined with Transforaminal Lumbar Interbody Fusion  

作　　者：Orlane Toto Ndome Nassourou Oumarou Haman Dimitri Fogue Jean Bruno Ndoumou Ronaldo Fonju Anu Indira Baboke Vincent De Paul Djientcheu Orlane Toto Ndome;Nassourou Oumarou Haman;Dimitri Fogue;Jean Bruno Ndoumou;Ronaldo Fonju Anu;Indira Baboke;Vincent De Paul Djientcheu(Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon;Department of Neurosurgery, Douala General Hospital, Douala, Cameroon;Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon;Department of Neurosurgery, Yaounde General and Central Hospitals, Yaounde, Cameroon;Cameroon Academy of Young Scientists, Yaounde, Cameroon)

机构地区：[1]Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon [2]Department of Neurosurgery, Douala General Hospital, Douala, Cameroon [3]Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon [4]Department of Neurosurgery, Yaounde General and Central Hospitals, Yaounde, Cameroon [5]Cameroon Academy of Young Scientists, Yaounde, Cameroon

出　　处：《Open Journal of Modern Neurosurgery》2024年第3期179-189,共11页现代神经外科学进展（英文）

摘　　要：Introduction: The choice of adopting unilateral pedicle screw fixation or using bilateral pedicle screw fixation in lumbar spinal stenosis remains controversial. In our context, very few studies have been performed comparing the clinical effectiveness of unilateral versus bilateral fixation in the surgical management of lumbar spinal canal stenosis. Objective: Evaluate the impact on quality of life and clinical efficacy of unilateral spondylodesis compared to bilateral spondylodesis in the surgical management of lumbar spinal canal stenosis at the Yaounde Central Hospital. Methods: This was a retrospective descriptive cross-sectional study for a period of 4 years, from June 2015 to June 2019. It involved all patients operated for lumbar canal stenosis and who underwent spondylodesis or spinal fusion at the neurosurgery department of the Yaounde Central Hospital. Results: A total of 68 participants were recruited during our study period. 32 (47%) of the study population were in the 50 - 60 age group, with a mean age of 56.98 years ranging from 41 to 75 years. Females, housewives and farmers were the most affected. In our study, 72% of patients had unilateral spondylodesis and 28% had bilateral fusion. Preoperatively, 71% of patients had insurmountable pain, refractory to medical treatment. At 3 months postoperatively, 73.7% of patients with bilateral setup had moderate pain compared to 69% of those with unilateral setup. At 6 months postoperatively, 79% of patients with bilateral fusion had mild pain compared to 82% of patients with unilateral setup. At 1 year postoperatively, all patients had mild pain. Preoperatively, 66.2% of patients were unable to walk and 19.1% of patients were bedridden according to the Oswestry score. At 3 months postoperatively, 10.2% of patients with unilateral setup were unable to walk compared to 10.5% of patients with bilateral fixation, while 67.3% of patients with unilateral fixation had moderate disability compared to 52.6% of patients with bilateral fixation. At 6 months postoperaIntroduction: The choice of adopting unilateral pedicle screw fixation or using bilateral pedicle screw fixation in lumbar spinal stenosis remains controversial. In our context, very few studies have been performed comparing the clinical effectiveness of unilateral versus bilateral fixation in the surgical management of lumbar spinal canal stenosis. Objective: Evaluate the impact on quality of life and clinical efficacy of unilateral spondylodesis compared to bilateral spondylodesis in the surgical management of lumbar spinal canal stenosis at the Yaounde Central Hospital. Methods: This was a retrospective descriptive cross-sectional study for a period of 4 years, from June 2015 to June 2019. It involved all patients operated for lumbar canal stenosis and who underwent spondylodesis or spinal fusion at the neurosurgery department of the Yaounde Central Hospital. Results: A total of 68 participants were recruited during our study period. 32 (47%) of the study population were in the 50 - 60 age group, with a mean age of 56.98 years ranging from 41 to 75 years. Females, housewives and farmers were the most affected. In our study, 72% of patients had unilateral spondylodesis and 28% had bilateral fusion. Preoperatively, 71% of patients had insurmountable pain, refractory to medical treatment. At 3 months postoperatively, 73.7% of patients with bilateral setup had moderate pain compared to 69% of those with unilateral setup. At 6 months postoperatively, 79% of patients with bilateral fusion had mild pain compared to 82% of patients with unilateral setup. At 1 year postoperatively, all patients had mild pain. Preoperatively, 66.2% of patients were unable to walk and 19.1% of patients were bedridden according to the Oswestry score. At 3 months postoperatively, 10.2% of patients with unilateral setup were unable to walk compared to 10.5% of patients with bilateral fixation, while 67.3% of patients with unilateral fixation had moderate disability compared to 52.6% of patients with bilateral fixation. At 6 months postopera

关 键 词：Lumbar Spinal Canal STENOSIS INSTRUMENTATION Surgery Quality of Life 

分 类 号：R73[医药卫生—肿瘤]