Decompressive Laminectomy Versus Laminectomy With Transpedicular Fixation in Lumbar Spinal Stenosis

NCT ID: NCT07281625

Last Updated: 2025-12-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

EARLY_PHASE1

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-10-01

Study Completion Date

2025-12-31

Brief Summary

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Lumbar spinal stenosis is a condition where the spinal canal becomes narrowed and can cause symptoms such as back pain, numbness, leg pain, and difficulty walking. Surgery is often considered when symptoms do not improve with medical treatment.

This study will compare two types of surgery used to treat lumbar spinal stenosis: decompressive laminectomy alone and decompressive laminectomy with transpedicular screw fixation. Patients will be randomly assigned to one of the two surgical options.

The purpose of this study is to determine which approach provides better pain relief, improved function, fewer complications, and better spinal stability after surgery.

Detailed Description

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Lumbar spinal stenosis (LSS) is a common degenerative spinal disorder causing neurogenic claudication, back pain, radiculopathy, and functional limitation. Multilevel stenosis is frequently associated with degenerative disc disease and facet joint hypertrophy. Decompressive laminectomy is a widely performed procedure; however, concerns exist regarding postoperative instability, which may affect long-term outcomes. Instrumented fixation using transpedicular screws may provide stability but also increases operative time, surgical risk, and healthcare cost.

This randomized controlled trial will be conducted at the Department of Neurosurgery, Services Hospital Lahore, over a six-month period. A total of 60 participants aged 30-60 years with MRI-confirmed multilevel lumbar spinal stenosis who have failed six weeks of conservative treatment will be enrolled using consecutive sampling and randomized into two equal study groups. Group A will undergo decompressive laminectomy alone, while Group B will undergo decompressive laminectomy with transpedicular screw fixation.

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Outcome measures will include operative time, postoperative complications, length of hospital stay, pain assessed using the Visual Analog Scale (VAS) at baseline, day 7, and 3 months, and functional status assessed using the Oswestry Disability Index (ODI) at baseline and 3 months. Postoperative radiographs will be used to evaluate spinal stability and bony fusion at 3 months.

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Data will be analyzed using SPSS version 25. Continuous variables will be presented as mean ± standard deviation and analyzed using an independent sample t-test. Categorical variables will be compared using the chi-square test, with a significance threshold of p ≤ 0.05. The study aims to evaluate whether decompression alone or decompression with transpedicular fixation results in superior clinical and radiological outcomes.

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Conditions

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Lumbar Spinal Stenosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Decompressive Laminectomy Only

Surgical decompressive laminectomy performed without instrumented fixation in patients with multilevel lumbar spinal stenosis.

Group Type ACTIVE_COMPARATOR

Decompressive Laminectomy

Intervention Type PROCEDURE

Surgical removal of the vertebral lamina to decompress the spinal canal in patients with multilevel lumbar spinal stenosis. No instrumentation or fixation is applied.

Decompressive Laminectomy With Transpedicular Screw Fixation

Intervention Type PROCEDURE

Surgical decompression via laminectomy combined with spinal stabilization using transpedicular pedicle screws for multilevel lumbar spinal stenosis to prevent postoperative instability and provide bony fusion.

Laminectomy With Transpedicular Screw Fixation

Surgical decompressive laminectomy combined with transpedicular screw fixation to provide additional spinal stability in patients with multilevel lumbar spinal stenosis.

Group Type EXPERIMENTAL

Decompressive Laminectomy

Intervention Type PROCEDURE

Surgical removal of the vertebral lamina to decompress the spinal canal in patients with multilevel lumbar spinal stenosis. No instrumentation or fixation is applied.

Decompressive Laminectomy With Transpedicular Screw Fixation

Intervention Type PROCEDURE

Surgical decompression via laminectomy combined with spinal stabilization using transpedicular pedicle screws for multilevel lumbar spinal stenosis to prevent postoperative instability and provide bony fusion.

Interventions

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Decompressive Laminectomy

Surgical removal of the vertebral lamina to decompress the spinal canal in patients with multilevel lumbar spinal stenosis. No instrumentation or fixation is applied.

Intervention Type PROCEDURE

Decompressive Laminectomy With Transpedicular Screw Fixation

Surgical decompression via laminectomy combined with spinal stabilization using transpedicular pedicle screws for multilevel lumbar spinal stenosis to prevent postoperative instability and provide bony fusion.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age 30-60 years
* Diagnosis of lumbar spinal stenosis based on MRI criteria (anteroposterior canal diameter \<10-15 mm or cross-sectional area \<75-145 mm²)
* Multilevel disc herniation
* Degenerative disc disease with Pfirrmann grade 3-5 on T2-weighted MRI
* Failure of at least six weeks of conservative treatment

Exclusion Criteria

* Previous history of lumbar spine surgery
* Spinal malignancy
* Congenital lumbar spinal stenosis, scoliosis, or kyphoscoliosis
* Lumbar spondylolisthesis grade 3-5
* Significant comorbidities including diabetes mellitus or ischemic heart disease
Minimum Eligible Age

30 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Punjab Health Care Commission

OTHER

Sponsor Role lead

Responsible Party

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Hira Umar

Doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Hira Umar, MBBS

Role: PRINCIPAL_INVESTIGATOR

SIMS

Locations

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Services Institute of Medical Sciences

Lahore, Punjab Province, Pakistan

Site Status RECRUITING

Countries

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Pakistan

Central Contacts

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Hira Umar, MBBS

Role: CONTACT

+92 317 4226862

Fazal Rehman, MBBS

Role: CONTACT

03227793559

Facility Contacts

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Burhan Amjad, MBBS

Role: primary

+92 300 5457200

Madiha Suleman, MBBS

Role: backup

03238092608

Other Identifiers

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SHL-LSS-Trial

Identifier Type: -

Identifier Source: org_study_id

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