الفهرس 
1. INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Lumbar canal stenosis has a large spectrum of potential treatment options since the disease itself has a wide range of severities. The patient’s physical and socioeconomic status should also be taken into account when diagnosing LCS. Today, most LCS patients fall between 50 and 60 years old with their condition commonly arising alongside age-associated degeneration of the lumbar and facet joints. However, females, heavy manual laborers, smokers, and individuals with a BMI above 30 had more risk for developing LCS. Traditional treatment of spinal stenosis involves wide laminectomy and undercutting of the medial facet with foraminotomy.
This prospective study included 60 patients that suffered from lumbar canal stenosis. All patients were presented to the Departments of Neurosurgery, Faculty of Medicine, Menoufia University.
All patients were subjected to informed consent taking before surgery, complete history taking which included the following symptoms: back pain, neurogenic Claudication, sciatica, motor deficit and sphincteric disturbance, full neurological examination, evaluation using Oswestry disability index, routine laboratory investigations, plain x-ray of lumbosacral spine, CT scan of the lumbosacral spine (preoperative and postoperative), magnetic resonance imaging (MRI).
This study included 60 patients, with age varying from 30 to 70 years old and mean age of (57.7±10.3). 41 patients were males (68.3%) and 19 patients were females (31.6%). In this study claudication and sciatica were present in 93% of cases, 6% of cases presented by motor deficit, cauda equina or sphincteric disturbance. Twenty patients were subjected to unilateral laminectomy with bilateral decompression surgery. Single level decompression was done for 11 cases, double levels decompression was done for 7 cases, and triple levels decompression was done for 2 cases, and the total levels were 31 levels. Twenty patients were subjected to Conventional laminectomy surgery. Single level decompression was done for 1 cases, double levels decompression was done for 8 cases, and triple levels decompression was done for 8 cases, quadruple levels decompression was done for 3 cases and the total levels were 53 levels. Twenty patients were subjected to Conventional laminectomy with posterolateral fusion surgery. Single level decompression was done for 2 cases, double levels decompression was done for 7 cases, triple levels decompression was done for 7 cases and quadruple levels decompression was done for 4 cases and the total levels were 53 levels.
Objective surgical data were obtained; they included the surgical time and estimated blood loss. Postoperative assessment was done immediately (one month) postoperative, and 6 months later. All patients were subjected to revising the preoperative symptoms, full neurological examination and evaluation using Oswestry disability index. For all patients, plain x-ray and CT scan of the lumbosacral spine were done postoperatively to ensure the extent of bone removal and adequacy of decompression and assessment of spinal stability with or without posterolateral fusion.
As regards the mean duration of surgery in unilateral laminectomy with bilateral decompression surgery was 3.0±0.59 hours for one level , 6.1±1.3 hours for two levels and 6.5 ± 0.0 hours for three levels , though in conventional laminectomy surgery the mean duration of surgery was 1.5±0.0 hours for one level , 2.9±0.88 hours for two levels and 3.13±0.84 hours for 3 levels , 3.8±1.9 hours for four levels , despite the fact that in conventional laminectomy with posterolateral fusion mean was 2.0±0.0hours for one level , 3.6±0.49 hours for two levels , 3.9±0.35 hours for three levels and 4.0±0.0hours for four levels (p-value=0.009).