다분절 척추관 협착증의 장분절 후측방 유합술 -5년 이상 장기 추시 결과-

초록

P u r p o s e : To evaluate the long-term results, and to analyze the clinical and radiological re sults of long-segment posterolateral fusion with instrumentation in multi-le vel spinal stenosis. M a t e r ia ls a n d M e t h o d s : A retrospective review was ca rried out on 62 patients, who had undergone long-segment poste rolateral fusion with instrumentation for the treatment of multi-level spinal stenosis from June , 1990 to M ay, 1998 with a minimal follow up of 5 years. T he clinical outcome s were eva luated using the Katz 's cla ssification and the O swestry disability scoring system (O DI). The radiological results were e valuated by monitoring the changes in the adjacent segments and the Lenke's grade for bony union. R e s u l t s : The me an follow-up duration was 94 (61 -15 6) months. T here we re 1 4 males and 48 females. T he mean age was 58.7 (37-78) years. The mean number of fused segments per pe rson were 3.97 (3-8) and the fusion techniques used in this study were eithe r the fixed fusion for 60 cases or floating fusion for 2. 48 (77 .4% ) cases showed results be yond 'satisfa ction'. The mean OD I was 30.0 (6-88% ), which means moderate disability. The O D I according to the number of fusion segments was checked for good results. Good results were observed in 25.8% , 3 3.6% , and 25.9% of patients with 3 , 4 or more than 5 fusion segments, re spectively. T here was no sta tistical difference . R e - ga rding the change s in the adjacent segments, disc spa ce narrowing, traction spur, endplate sclerosis and va cuum phenomenon was observed in 25 (40.3% ), 2 6 (41.9% ), 2 2 cases (35.5% ) and 7 ca ses (11.3% ), respectively. 3 4 (55 .0% ) cases had more than one change in the adjacent segmentsbut the O D I was 38.0% for "good results" and 25 (7 4.0% ) ca ses were "satisfied". In all cases except for one, bony union showed Lenke's A or B degre e by radiographs. Pseudarthrosis was dete cted in 1 (1.6% ) case . Conclusion : In the analysis of long-term clinica l and radiological results for multi-level spinal stenosis treatment, poste rolateral fusion with instrumentation might be good results irrespective of the fusion level and the change in adjacent segment.

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