Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Orthopedic Surgery

Background:degenerative spondylolisthesis is a disorder that causes slip of one vertebra over the one below due to degenerative changes,with slip progression, facet hypertrophy and buckling of ligamentum flavum spinal canal stenosis occurs. Symptoms include low back pain, neurogenic claudication, and radiculopathy.Surgical treatment is indicated when conservative management fails, surgical options include decompression alone or decompression with fusion (posterolateral / interbody fusion) Purpose:to evaluate the efficacy of decompression only surgery in relieving symptoms in patients with spinal canal stenosis associated with first degree degenerative spondylolithesis. Methods:a prospective cohort study including 20 Patients diagnosed with spinal canal stenosis associated with first degree degenerative spondylolithesis; treated by decompression only surgery (open and minimally invasive). Pain and disability assessment pre and post operatively by VAS, Oswestry and JOABPEQ scores with X- ray dynamic views pre and postoperative.Results: This study proves that decompression only surgery carries satisfactory functional outcomes for carefully selected patients who suffer from canal stenosis associated with first degree spondylolithesis. It also proves that minimally invasive technique although is a technically demanding procedure; but still an effective, less invasive, and safe method to relieve patients' symptoms.Conclusion: decompression surgery without fusion is a highly cost benefit effective procedure that reliefs patient symptoms and avoid the adverse effects of fusion to carefully selected patients based on clinical as well as radiological data collected by the surgeon

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