Servicemen are at high risk for musculoskeletal injuries, particularly lumbar spinal stenosis (LSS), due to the physical demands of combat and training. LSS often leads to significant disability, impacting soldiers’ quality of life and operational readiness. Surgical intervention is frequently needed, but the optimal technique for military patients remains debated. This study aimed to evaluate the outcomes of different surgical approaches for treating LSS, unilateral laminectomy for bilateral decompression (ULBD), open decompression, and decompression laminectomy with transpedicular stabilization, in wounded Ukrainian military personnel, focusing on pain relief, functional recovery, and rehabilitation timelines. Sixty-four male servicemen (43 ± 4 years) with LSS were divided into three groups according to the surgery type: the servicemen with LSS were divided into three groups according to the surgery type: Group 1 (ULBD), Group 2 (open decompression), and Group 3 (decompression with transpedicular stabilization). Preoperative and postoperative assessments included pain intensity (Visual Analog Scale), quality of life and disability (Oswestry Disability Index), and functional recovery using the International Classification of Functioning, Disability, and Health. Follow-up evaluations were conducted at one week, one month, and six months postsurgery. Postoperative outcomes revealed significant pain reduction across all groups. However, Group 3 patients exhibited slower recovery, with persistent moderate impairments in quality of life and mobility six months postsurgery. In contrast, Groups 1 and 2 demonstrated faster rehabilitation, with minimal impairments by six months. The time to return to duty was notably longer in Group 3 (80.8 ± 20.8 days) than in Group 1 (27.4 ± 15.3 days) and Group 2 (38.4 ± 16.6 days). ULBD and open decompression techniques offer faster recovery and better functional outcomes for military personnel with LSS compared to decompression with transpedicular stabilization. These findings suggest that less invasive procedures may be more suitable for military patients requiring a swift return to duty.
Меленко et al. (Tue,) studied this question.