Long-term follow-up review of patients who underwent laminectomy for lumbar stenosis: a prospective study

Abstract

<jats:sec> <jats:title>Object</jats:title> <jats:p>Decompressive laminectomy for stenosis is the most common operation performed on the lumbar spine in older patients. This prospective study was designed to evaluate long-term results in patients with symptomatic lumbar stenosis.</jats:p></jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Between January 1984 and January 1995, 170 patients underwent surgery for lumbar stenosis (86 patients), lumbar stenosis and herniated disc (61 patients), or lateral recess stenosis (23 patients). The male/female ratio for each group was 43:43, 39:22, and 14:9, respectively. The average age for all groups was 61.4 years. For patients with lumbar stenosis, the success rate was 88.1% at 6 weeks and 86.7% at 6 months. For patients with lumbar stenosis and herniated disc, the success rate was 80% at 6 weeks and 77.6% at 6 months, with no statistically significant difference between the two groups. For patients with lateral recess stenosis, the success rate was 58.7% at 6 weeks and 63.6% at 6 months; however, the sample was not large enough to be statistically significant. One year after surgery a questionnaire was sent to all patients; 163 (95.9%) responded. The success rate in patients with stenosis had declined to 69.6%, which was significant (p = 0.012); the rate for patients with stenosis and herniated disc was 77.2%; and that for lateral recess stenosis was 65.2%. Another follow-up questionnaire was sent to patients 1 to 11 years after surgery (average 5.1 years); 146 patients (85.9%) responded, 10 (5.9%) were deceased, and 14 (8.2%) were lost to follow-up review. At 1 to 11 years the success rate was 70.8% for patients with stenosis, 66.6% for those with stenosis and herniated disc, and 63.6% for those with lateral recess stenosis. Eleven patients who underwent reoperation were included in the group of patients whose surgeries proved unsuccessful, regardless of their ultimate outcome. There was no statistically significant difference in outcome between 1 year and 1 to 11 years with respect to stenosis, stenosis with herniated disc, and lateral recess stenosis.</jats:p></jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>In conclusion, long-term improvement after laminectomy was maintained in two-thirds of these patients.</jats:p></jats:sec>

Survivorship analysis of 150 consecutive patients with DIAM™ implantation for surgery of lumbar spinal stenosis and disc herniation

“…However, age, gender, and diagnosis were not significant risk factors for reoperation of DIAM TM implantation surgery. Decompressive surgery such as laminectomy or discectomy is the most common operation procedure for lumbar spinal stenosis or disc herniation without instability, which results in early favourable outcome [2,11]. However, the outcome usually deteriorates over time due to recurrent stenosis or disc herniation or instability.…”

“…Decompressive surgery has been shown to be a successful treatment in relieving symptoms of lumbar spinal stenosis and disc herniation without instability [2,12]. However, previous studies have noted deterioration of the early favourable results of decompressive surgery over time due to post-operative instability or recurrent spinal stenosis or disc herniation [10,11,28]. Therefore, addition of fusion surgery has been performed to reduce the failure or reoperation rate at the level of decompressive surgery [19,20].…”

Lower Limb Pain Caused by Insufficient Muscular Microcirculation

“…The success rates fall to around 30 % after a second back surgery, 15 % after the third, and to 5 % after the fourth surgery [8]. It is a disabling condition that affects approximately 30 % of spinal surgery patients and it is difficult to treat these patients with conservative therapy [5,9]. Patients with FBSS typically suffer many associated problems, including operations of the lumbosacral area, depression and sleeping problems, family and economic problems, high-dose opioid dependence, and low probability that further surgery will result in pain relief [10].…”

Cost-effectiveness of three treatment strategies for lumbar spinal stenosis: Conservative care, laminectomy, and the Superion interspinous spacer

“…Open lumbar laminectomy remains the gold standard for surgical decompression in patients with medically refractory LSS and has been shown to have good long-term efficacy. 5,[9][10][11][12][13] However, open lumbar laminectomy has been shown to be associated with post-operative complication rates ranging from 12 to 29%, depending on comorbidity status, which is particularly important since LSS is predominantly a disease of the elderly, a demographic inherently associated with higher rates of comorbidities. [14][15][16][17][18] As a result, less invasive surgical treatment strategies have been explored to manage patients with LSS refractory to conservative care.…”

“…2 Furthermore, LSS continues to increase in prevalence and is one of the most common reasons for surgery in elderly patients (>65 years old). [3][4][5][6] The cost to society in the United States resulting from this disease process has been estimated in the tens of billions of dollars annually. 7,8 The initial treatment of LSS consists of various nonoperative approaches including physical therapy, pain medications (NSAIDs, mild opioids), and epidural steroid injections, referred to as conservative care (CC) in this study.…”