Segmental Decompression Versus Wide Decompression With Fixation in Treatment of Degenerative Lumbar Canal Stenosis

Lumbar spinal canal stenosis secondary to degenerative disease is a common condition associated with the aging process that may ultimately lead to the compression of neural elements within the lumbar canal. The degenerative process is often a response to hypermobility and can contribute to spinal instability. While conservative treatment is generally regarded as the first-line approach, surgical decompression is indicated for symptom alleviation in patients whose symptoms persist despite adequate nonoperative management. The primary objective of surgery for lumbar stenosis is the relief of neurogenic claudication, followed by an improvement in walking capacity and a reduction of leg pain.

Over the past two decades, spinal surgeons have become increasingly familiar with instrumentation techniques, leading to a marked rise in the use of pedicle screws and rods for the treatment of degenerative lumbar stenosis. However, attention has recently shifted toward reassessing the routine use of these fusion procedures. A sustained debate continues among experts regarding the optimal surgical management, aiming to better define the indications for fusion and avoid its unnecessary application. This study aims to provide emerging evidence to help establish clearer conclusions by evaluating whether segmental decompression alone or wide decompression with fixation offers superior clinical and radiological advantages for selected patient groups.

The trial will be conducted across the Neurosurgery departments of Assiut University Hospitals and Misr University Teaching Hospital. Patient data will be collected using standardized, coded case report forms to ensure confidentiality.