Impact of redundant nerve roots on lumbar decompression and fusion for lumbar spinal stenosis: a retrospective controlled study based on surgical complications.

Abstract

To investigate the impact of redundant nerve roots (RNRs) on the surgical complications of lumbar decompression and fusion for lumbar spinal stenosis (LSS). A retrospective study was conducted on 263 eligible patients with LSS who underwent lumbar decompression and fusion between January 2019 and January 2024. Patients were stratified into two cohorts based on the presence or absence of RNRs identified on preoperative sagittal magnetic resonance imaging: the RNRs group (n=87) and the Non-RNRs group (n=176). Demographic data, radiological parameters, surgical outcomes, and postoperative complications were systematically compared between the groups. The two groups were comparable with respect to demographic data and radiological parameters (P > 0.05). Regarding surgical outcomes, no significant intergroup differences were observed in incision length, surgical methods, or fused segments (P > 0.05). In contrast, the RNRs group exhibited a significantly longer operative time (208 ± 40 min vs. 194 ± 35 min) and greater intraoperative blood loss (393 ± 108 ml vs. 357 ± 118 ml) than the Non-RNRs group (P < 0.05). Analysis of complications revealed no significant differences in the rates of nerve injury or wound infection (P > 0.05). However, the incidence of cerebrospinal fluid leakage was significantly higher in the RNRs group than in the Non-RNRs group (12% vs. 4.0%, P < 0.05). For LSS patients underwent lumbar decompression and fusion surgery, RNRs may be associated with prolonged operative duration, elevated intraoperative blood loss, and heightened risk of cerebrospinal fluid leakage, which warrant considerable clinical attention.