Outcome of Posterior Decompression and Stabilization by Pedicle Screws and Rods without Interbody Fusion in Multilevel Lumbar Spinal Canal Stenosis

Background: Lumbar spinal canal stenosis is a common degenerative condition that causes neurogenic claudication and functional disability. Traditional decompression with interbody fusion restores stability but increases rigidity and the risk of adjacent segment degeneration. Stabilization without interbody fusion has been proposed to reduce surgical morbidity. This study aimed to evaluate the clinical and functional outcomes of posterior decompression and pedicle screw–rod stabilization without interbody fusion in patients with multilevel lumbar spinal canal stenosis. Methods : This prospective interventional study was conducted at Dhaka Medical College Hospital from September 2023 to August 2024. Twenty patients aged 35–75 years with MRI-confirmed multilevel lumbar stenosis refractory to conservative therapy underwent posterior decompression and stabilization via the use of pedicle screws and rods without interbody fusion. Patients were followed up at 6 months post-operatively. Pain, disability and motor function were assessed via the visual analog scale (VAS), the Oswestry Disability Index (ODI), and the Medical Research Council (MRC) scale, respectively. The functional outcome was evaluated via the modified MacNab criteria. Statistical analysis was performed via paired t tests and the exact McNemar test, with significance set at p < 0.05. Results: The mean age of the patients was 55 ± 7.23 years, with a female predominance (60%). Significant improvements were observed in the mean VAS score for leg pain (6.72 ± 0.55 to 1.35 ± 0.49, p < 0.001) and back pain (6.80 ± 0.50 to 2.30 ± 0.57, p < 0.001). The ODI improved from 57.70 ± 2.18 to 16.60 ± 3.36 (p < 0.001). Motor deficits decreased from 45% preoperatively to 10% postoperatively (p = 0.016). Postoperative complications were minimal, where superficial wound infection was 15% and discitis was 5%. According to the Macnab criteria, 75% of patients had excellent and 25% good outcomes. Conclusions: Posterior decompression with pedicle screw–rod stabilization without interbody fusion offers substantial pain relief, functional recovery, and stable fixation with minimal complications in multilevel lumbar canal stenosis. It represents a safe alternative to traditional fusion surgery. J Dhaka National Med. Coll. Hos. 2026; 32 (02): 33-40