Outcome after laminectomy for lumbar spinal stenosis. Part I: Clinical correlations.
All patients who underwent decompressive lumbar laminectomy in the Washtenaw County, Michigan metropolitan area during a 7-year period were studied for the purpose of defining long-term outcome, clinical correlations, and the need for subsequent fusion. Outcome was determined by questionnaire and physical examination from a cohort of 119 patients with an average follow-up evaluation interval of 4.6 years. Patients graded their outcome as much improved (37%), somewhat improved (29%), unchanged (17%), somewhat worse (5%), and much worse (12%) compared to their condition before surgery. Poor outcome correlated with the need for additional surgery, but there were few additional significant correlations. No patient had a lumbar fusion during the study interval. The outcome after laminectomy was found to be less favorable than previously reported, based on a patient questionnaire administered to an unbiased patient population. Further randomized, controlled trials are therefore necessary to determine the efficacy of lumbar fusion as an adjunct to decompressive lumbar laminectomy.
Tuite
G F
GF
Section of Neurosurgery, University of Michigan Hospital, Ann Arbor.
Stern
J D
JD
Doran
S E
SE
Papadopoulos
S M
SM
McGillicuddy
J E
JE
Oyedijo
D I
DI
Grube
S V
SV
Lundquist
C
C
Gilmer
H S
HS
Schork
M A
MA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007796:Laminectomy; D007866:Leg / Q000503:physiopathology; D017116:Low Back Pain / Q000503:physiopathology; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology; D017060:Patient Satisfaction; D018579:Patient Selection; D012086:Reoperation; D012678:Sensation Disorders / Q000503:physiopathology; D013123:Spinal Fusion; D013130:Spinal Stenosis / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology