Iranian Journal of Neurosurgery (Jan 2020)
Post-operative Morbidity and Mortality of Lumbar Spinal Stenosis at one Teaching Hospital in North-eastern Benin.
Abstract
Background & Aim: Surgical management of lumbar spinal stenosis (LSS) is a common practice. The aim of this study to was to report morbidity and mortality observed during surgical treatment of LSS and the outcome of these patients after management over an 8-year study period. Methods & Materials/Patients: It was a retrospective, descriptive and transversal study performed at Departmental Teaching Hospital of Borgou in Republic of Benin (West Africa) from January 2010 to December 2018. This study concerned patients who underwent surgical management for LSS. Each type of complication, its management and the patient’s outcome was registered. Results: During the study period, 270 patients underwent laminectomy for lumbar spinal stenosis; 239 (88.5%) were selected. These patients were divided into 135 men (56.5%) and 104 women (43.5%). The mean age of the patients was 52.36 ± 10.94 years. Laminectomy was performed on one, two and three lumbar spinal segments in 42(17.6%), 133(55.6%) and 64 (26.8%) cases respectively. Laminectomy was associated with dissectomy in 15 patients (6.3%). No arthrodesis with spinal fixation was performed. The postoperative evolution was simple and uncomplicated for 215 (90%) patients. Functional postoperative results were considered excellent, good, acceptable and poor in 32.1%, 52.1%, 10.9% and 4.9% of cases respectively. Five types of complications were observed in 22 patients (9.2%). A reoperation was performed in 4 (1.6%) patients. These different complications was : dural tear (4.6%), Wound infection (3.3%), Stroke (0.8%), Pseudomeningocele (0.4%) and Cauda equina syndrom (0.4%). Mortality was 0.8% (n=2). Conclusion: Lumbar canal stenosis surgery is not without complications. Careful selection of patients, consideration of risk factors, and selection of an appropriate surgical strategy can reduce or avoid these complications.