Seven- to 10-year outcome of decompressive surgery for degenerative lumbar spinal stenosis.
METHODS
Retrospective review and prospective follow-up of 88 patients who had decompressive laminectomy with or without fusion from 1983 to 1986.


OBJECTIVE
To determine the 7- to 10-year outcome of surgery for degenerative lumbar spinal stenosis.


BACKGROUND
There is limited information on the impact of surgery for lumbar spinal stenosis on symptoms, walking ability, and satisfaction, as well as reoperation.


METHODS
Patients completed standardized questionnaires in 1993 that included items about reoperations, back pain, leg pain, walking capacity, and satisfaction with surgery. Associations between preoperative demographic and clinical variables and outcomes 7 to 10 years after surgery were evaluated in univariate and multivariate analyses.


RESULTS
Average preoperative age was 69 years and eight patients received fusion. Of 88 patients in the original cohort, 20 (23%) were deceased and 20 (23%) had undergone reoperation by 7- to 10-year follow-up. Fifty-five patients answered questionnaires. Average duration of follow-up was 8.1 years. Thirty-three percent of the respondents had severe back pain at follow-up, 53% were unable to walk two blocks, and 75% were satisfied with the results of surgery. The severity of current spine-related symptoms was a stronger correlate of physical functional status at the time of follow-up than age or nonspinal comorbid conditions.


CONCLUSIONS
Seven to 10 years after decompressive surgery for spinal stenosis, 23% of patients had undergone reoperation and 33% of respondents had severe back pain. Despite a high prevalence of nonspinal problems in this elderly cohort, spinal symptoms were the most important correlate of reduced functional status.
Katz
J N
JN
Departments of Rheumatology and Immunology, Brigham and Women's Hospital, Boston, MA, USA.
Lipson
S J
SJ
Chang
L C
LC
Levine
S A
SA
Fossel
A H
AH
Liang
M H
MH
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D007796:Laminectomy; D008137:Longitudinal Studies; D008161:Lumbosacral Region; D008875:Middle Aged; D010146:Pain; D017060:Patient Satisfaction; D011184:Postoperative Period; D011446:Prospective Studies; D012086:Reoperation; D012189:Retrospective Studies; D013123:Spinal Fusion; D013130:Spinal Stenosis / Q000503:physiopathology / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D016138:Walking