Initial Efficacy After Lateral Lumbar Interbody Fusion in Degenerative Lumbar Spinal Stenosis Classified as Schizas Grade A to D.

Abstract

This study was to evaluate the initial efficacy of lateral lumbar interbody fusion (LLIF) in treating degenerative lumbar spinal stenosis (DLSS), encompassing a spectrum of stenosis severity from minor to extreme cases. This retrospective study analyzed the outcomes of 43 patients with DLSS, involving 55 surgical segments, who underwent LLIF. Clinical efficacy and radiographic parameters were recorded during the perioperative period and at the final follow-up. Pursuant to the Schizas' classification criteria, the 55 surgical segments were categorized into 2 groups: the Schizas grade A or B group and the C or D group. Simultaneously, the 43 patients were divided into 2 groups: the minor-moderate stenosis (MM) group and the severe-extreme stenosis (SE) group. Comparative analyses were subsequently conducted. All patients successfully underwent the LLIF procedure, without the need for additional posterior decompression surgery. Both 16 MM and 27 SE group patients demonstrated significant improvements in clinical efficacy scores compared to their preoperative baselines (P < 0.001). Furthermore, there were no statistically significant differences between the MM group and the SE group in postoperative clinical metrics (P > 0.05). Both 23 Schizas grade A or B and 32 C or D group segments exhibited significant postoperative improvements in radiographic parameter values (P < 0.001), with no statistically significant differences between the 2 groups (P > 0.05). Under certain indications, patients with varying degrees of DLSS, ranging from mild to extreme, can achieve favorable outcomes through LLIF, and preoperative imaging revealing severe or extreme stenosis does not automatically disqualify patients from undergoing indirect decompression surgery.