Study of lumbar canal stenosis and its outcome after surgical management in central India

Background: Lumbar canal stenosis is a painful and potentially disabling condition often encountered in adults. Treatment of lumbar canal stenosis may consist of conservative approach to lumbar canal stenosis consists of rest, lumbar bracing, activity modification and analgesics. Surgical management consists of decompressive laminectomy, laminotomy or facetectomy. In the present study, authors evaluate the outcome in patients of lumbar canal stenosis managed surgically with decompressive laminectomy.Methods: A 50 patients with degenerative lumbar canal stenosis visiting Kasturbha hospital, Sewagram, Wardha from November 2016 to April 2017 were taken up for the study. Patients were taken up for laminectomy and decompression of the affected nerve roots using medial facetectomy. Post operatively patients were regularly followed up at monthly intervals. The ODI score was calculated at the end of 6 months and compared with the baseline score.Results: Fifty patients (mean age-42.9 years) underwent laminectomy and decompression. Baselines ODI score was 71.2±6.4. After 6 month follow up, the score improved significantly to 21±15.6 which was statistically significant.Conclusions: Operative treatment in patients of degenerative lumbar canal stenosis yields excellent functional results as observed based on the ODI score provided case selection is done properly

Surgical treatment of lumbar canal stenosis with concomitant aggressive vertebral haemangioma

Vertebral hemangiomas are the most common benign spinal tumours which are asymptomatic, slow-growing benign vascular malformations. They usually involve the vertebral body. However, the involvement of the posterior elements may present with spinal cord compression. Vertebral hemangiomas exist as a continuum of manifestations and lesions ranging from the common asymptomatic forms to rare compressive lesions. Presence of multilevel spinal canal stenosis along with an atypical vertebral hemangioma with cord is a rare condition and represents a treatment challenge. We report a case of spinal canal stenosis at L2 to L4 spinal levels along with an atypical vertebral hemangioma at L3 vertebra with extension to bilateral pedicles. This tumour caused neurological manifestations and was surgically treated with posterior decompression and stabilization with transpedicular screws and rods along with vertebroplasty for the hemangioma. Presence of an atypical hemangioma with co-existing spinal canal stenosis is a rare indication of spinal fusion. Vertebroplasty for the treatment of hemangioma in such cases is imperative