Abstract

Background: Lumbar spinal stenosis (LSS) is a prevalent degenerative condition in the elderly, often leading to significant pain and functional disability that requires surgical intervention. And, aim this study was to evaluate the functional outcomes, pain relief, and complication rates of surgical management by applying midline wide excision approach for lumbar spinal stenosis in elderly patients.  Methods: This study was conducted at Shaheed Ziaur Rahman Medical College Hospital, Bogura, from January 2023 to December 2024. A purposive sample of 47 patients aged 60 years and above with symptomatic LSS refractory to conservative management underwent midline wide excision. Primary outcomes were measured using the Oswestry Disability Index (ODI) and the Visual Analog Scale (VAS) for leg pain preoperatively and at 6 months postoperatively. Complications were recorded. Data were analyzed with paired t-tests. Results: The study demonstrated significant improvements in primary outcomes. The mean ODI score decreased from 68.2 to 24.5 (p<0.001). The mean VAS score for leg pain improved from 8.1 to 2.3 (p<0.001). The overall complication rate was 12.8%, with dural tear and surgical site infection being the most common (4.3% each). The majority of patients (87.2%) reported good to excellent satisfaction.  Conclusion: Midline wide excision is a highly effective and safe procedure for elderly patients with lumbar spinal stenosis, providing significant functional improvement and pain relief with an acceptable complication profile. It is a recommended treatment for carefully selected patients in this demographic.

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