Intracanal bridging ossification after lumbar decompression: a case report and imaging analysis of postoperative bone regrowth

Vollständiger Abstract

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Postoperative bone regeneration following lumbar decompression is an important factor affecting long-term clinical outcomes. However, bridging ossification between the laminectomy defect and the posterior vertebral body margin has rarely been reported, and its imaging characteristics and underlying mechanisms remain poorly understood. Here, we report a case of bridging ossification following lumbar decompression and discuss its possible mechanisms and imaging manifestations based on the relevant literature. A patient presented in March 2024 with low back pain accompanied by right lower-extremity numbness, pain, and muscle weakness and was diagnosed with lumbar spinal stenosis. The patient underwent right-sided unilateral biportal endoscopic (UBE) decompression at L4–5, after which the symptoms improved and the patient was discharged. In June 2026, the patient developed recurrent radiating pain and numbness in the right lower extremity, with inadequate response to conservative treatment. CT revealed continuous bridging ossification between the original laminectomy defect and the posterior margin of the vertebral body, indicating osseous restenosis. Pulsed radiofrequency neuromodulation was subsequently performed at the right L4–5 foramen, resulting in symptomatic improvement, and the patient was discharged. Based on imaging findings and literature review, this phenomenon may be associated with the combined effects of a pre-existing degenerative osteogenic tendency, postoperative bone remodeling, alterations in local mechanical stress, and degenerative osteophyte formation. This case, together with a review of the relevant literature, summarizes the imaging manifestations of postoperative bone regeneration and may provide a reference for long-term postoperative follow-up, the diagnosis and management of osseous restenosis, and further investigation of imaging patterns of postoperative bone regeneration.