Single Incision Tubular Decompression to Treat Multi-level Lumbar Spinal Stenosis: A Retrospective Review

Abstract

Objective: To evaluate the technical feasibility and assess the clinical outcomes of tubular decompression (TD) in cases of multilevel lumbar canal stenosis operated through a single incision. TD has established itself in the surgical management of single level lumbar stenosis. Literature on performance of TD for multilevel stenosis through a single incision are non-existent.Methods: All patients undergoing TD for multilevel lumbar stenosis through a single incision from January 2007 to January 2018 were included. Patient demographics, operative and peri-operative details were documented. Patient based clinical outcomes, namely Visual Analogue Scale (VAS) scale for back and leg pain and Oswestry Disability Index (ODI) were assessed. Results: Favorable tube trajectory and adequate decompression could be achieved through a single incision to decompress multiple levels. The VAS improved from mean 31.5 (2–5) to 20.8 (1–4) and 71.4 (4–9) to 21 (1–5) for back and leg pain respectively; while the ODI improved from a mean 44.68.6 (32–68) to 20.25.3 (16–42) at 3 months post-op and was maintained at 10.8 (1–4), 1.60.67 (1–3) and 192.9 (16–26) respectively at 2 years follow-up.Conclusion: TD for multilevel stenosis done through a single incision is a feasible option with good to excellent results.