title: Only walking matters-assessment following lumbar stenosis decompression.
abstract: Multiple outcome measures exist to evaluate the outcomes of spinal decompression surgery; however, these tend to be complex and are difficult to express to the patient pre-operatively to accurately guide their expectations. We present outcomes, in terms of walking distance measurement, of a prospective single surgeon series of 76 consecutive patients with spinal stenosis.
  
  
  
  76 patients (mean age 68.8 years; 48-91 years) had decompression surgery using spinous process osteotomy. Accurate measurement of walking distance was used as an outcome measure, and factors that affect it were evaluated. Walking distance was measured pre-operatively, post-operatively and at 3 months follow-up using a measuring wheel. The minimum follow-up was 5 years.
  
  
  
  The mean distances walked were 78.1, 419.9 and 1285 m, respectively. Pre-operative disc height (p = 0.023) and male gender (p = 0.039) predicted a significant improvement in walking distance, while age (p = 0.23), ASA grade (p = 0.39) and the number of levels operated on (p = 0.89) did not significantly affect the increase in walking distance. 12 patients experienced post-operative complications (15.8%), and at last clinical follow-up (6.3 years, 5.1-6.9 years) 27 patients (35.5%) had residual leg symptoms and 8 had undergone further revision procedures (10.5%).
  
  
  
  This study demonstrates that walking distance is an accurate and accessible method of determining surgical outcomes.
authors.affiliation: Robert Jones and Agnes Hunt Hospital, Oswestry, UK.
authors.forename: S
authors.initials: S
authors.lastname: Budithi
authors.affiliation: Robert Jones and Agnes Hunt Hospital, Oswestry, UK. rohitkrdhawan@yahoo.com.
authors.forename: Rohit
authors.initials: R
authors.lastname: Dhawan
authors.affiliation: Robert Jones and Agnes Hunt Hospital, Oswestry, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Cattell
authors.affiliation: Robert Jones and Agnes Hunt Hospital, Oswestry, UK.
authors.forename: Birender
authors.initials: B
authors.lastname: Balain
authors.affiliation: Robert Jones and Agnes Hunt Hospital, Oswestry, UK.
authors.forename: David
authors.initials: D
authors.lastname: Jaffray
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011446:Prospective Studies; D013130:Spinal Stenosis / Q000601:surgery*; D016138:Walking
keywords: Measuring wheel; Self-paced walking test; Spinal stenosis decompression; Walking distance