Only Surgical Decompression Is Sufficient for Multilevel Lumbar Spinal Stenosis with Calcified Disc Protrusion and Vacuum Disc: Case Reports

Abstract

The purpose of this report was to share our successful cases of only surgical decompression for symptomatic multilevel lumbar spinal stenosis, by assessing treatment outcomes and perioperative complications. Two patients who had only surgical decompression for symptomatic multilevel lumbar spinal stenosis in March and May 2021 were investigated. They were preoperatively diagnosed with the calcified disc protrusion and vacuum disc in the intervertebral space by magnetic resonance imaging (MRI) and computed tomography (CT). The chief complaints were severe low back pain and bilateral sciatica 2 or 3 months ago. The patients reported also reported difficulty walking due to sciatica, for which they were admitted to Daegu Wooridul Spine Hospital. Under general anesthesia unilateral laminotomy for bilateral decompression (ULBD) was performed and discectomy was not done on the stenosis levels. Treatment outcomes were analyzed by preoperative and postoperative visual analog scale (VAS) for low back pain and sciatica (Back VAS and Leg VAS), improvement in walking, and postoperative MRI. Treatment outcomes were favorable: Low back pain and bilateral sciatica showed a VAS score improvement (Back VAS=3, Leg VAS=3), the patient’s walking was improved, and on a postoperative MRI of the two patients, the thecal sac was released sufficiently. The patients developed no perioperative complications. Only surgical decompression is an effective method for symptomatic multilevel lumbar spinal stenosis with calcified disc protrusion and vacuum disc in not the spinal canal but the intervertebral space.