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Surgical Management of Lumbar Degenerative Spinal Stenosis with Spondylolisthesis via Posterior Reduction with Minimal Laminectomy

Bednar, Drew A.

Journal of Spinal Disorders & Techniques: April 2002 - Volume 15 - Issue 2 - p 105-109
Original Contributions

Degenerative lumbar spondylolisthesis with spinal stenosis is commonly treated with laminectomy. Recent reports have consistently supported the incremental clinical benefit of associated in situ arthrodesis with or without instrumentation. Resection of the lamina may result in intraoperative dural tear or epidural scar formation. Fifty-six consecutive patients with back pain, neuroclaudication, or both, in addition to degenerative spondylolisthesis with spinal stenosis, underwent a surgical procedure that incorporated fusion after reduction of the spondylolisthesis deformity with preservation of the lamina and the balance of the posterior elements. Clinical records were reviewed and patients interviewed at a mean of 33 months after surgery. Oswestry Disability Index scores were obtained independently at baseline and at a late review. Late imaging was available a mean of 28 months after operation. Clinical and imaging analyses and Oswestry scoring confirmed results comparable to the published outcomes of in situ fusion after formal laminectomy. Resection of the lamina may not be necessary in the treatment of degenerative lumbar spinal stenosis with spondylolisthesis.

Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada

Received October 31, 2001; accepted November 15, 2001.

Address correspondence to Dr. D. A. Bednar, Hamilton Community Medical Center, Suite M-9, 414 Victoria Avenue North, Hamilton, Ontario, Canada, L8L 5G8. E-mail:

© 2002 Lippincott Williams & Wilkins, Inc.