ABSTRACT

Objective: To investigate the changes and improvement in neurological symptoms of postoperative period lumbar spinal stenosis (LSS) and lumbar disc herniation (LDH) patients and discover pathognomonic radiological features.

Methods: Forty-four LSS and 37 LDH patients with mean age of 58.70 ± 14.58 (24–81) that have undergone decompressive laminectomy, posterior lumbar stabilization or lumbar microdiscectomy were enrolled. Patients’ demographic data and pre- and post-operative neurological symptoms analysed with the Japanese Orthopaedic Association (JOA) scale were recorded and compared with the magnetic resonance imaging (MRI) results. We have measured from the patients’ MRI images of axial sections before a decision of surgery. We have also evaluated and graded the protrusion degrees of herniated discs in the sagittal plane of MRI. The transverse interpedicular diameter (TIP), midline antero-posterior (M-AP), interfacet (IF) values and JOA scale were compared between LDH and LSS.

Results: All measured osteal body diameter mean values (TIP, M-AP, IF) in LSS were less than the LDH group. Only IF mean values were shown to be statistically significant (p < 0.004). Sagittal disc section measurements were not statistically significant for LSS and LDH (p < 0.182). The pre- and post-surgery JOA score mean values of the LDH were higher than the LSS group (p < 0.005). The lumbar microsurgery discectomy recovery rate was higher than the posterior segmental instrumentation.

Conclusion: The TIP, M-AP, IF diameters decreased with age, which was the main pathological mechanism of LSS development. This suggests that the degenerative process of the narrowing spinal canal, which increases with age, is responsible for LSS presentation. Lumbar spinal stenosis (LSS) has a relationship with facet arthropathy over other parameters.