Surgical outcome of 438 patients treated surgically for lumbar spinal stenosis.

STUDY DESIGN

A retrospective, follow-up study.

OBJECTIVES

To investigate the overall outcome of surgery for lumbar spinal stenosis and to investigate the preoperative factors affecting outcome.

SUMMARY OF BACKGROUND DATA

The success rates of surgical intervention for lumbar spinal stenosis vary, and few preoperative factors have been found to be significantly correlated to surgical outcome.

METHODS

A total of 438 patients (183 women, 255 men) who underwent decompressive surgery for lumbar spinal stenosis were re-examined and evaluated for outcome 4.3 years after surgery. Outcome was based on subjective disability, which was assessed using the Oswestry low back pain questionnaire. The preoperative data (clinical documentation, length of laminectomy, and radiographs) were collected from patient records that had been stored in the hospital. Preoperative factors affecting outcome were reported.

RESULTS

The mean value of the Oswestry disability score of these 438 patients was 34 +/- 18 (women, 36.3 +/- 17; men, 32.3 +/- 18; P < 0.05). Age did not influence general outcome. The proportion of good to excellent outcomes of all 438 patients was 62% (women, 57%; men, 65%). Diabetes, hip joint arthrosis, and preoperative fracture of the lumbar spine seemed to be associated with poor outcome. The ability to work before or after surgery and a history of no prior back surgery were predictive of good outcome.

CONCLUSION

The results suggest that clear myelographic stenosis and no prior surgical intervention, no comorbidity of diabetes, no hip joint arthrosis, and no preoperative fracture of the lumbar spine are factors associated with a good outcome in surgical management of lumbar spinal stenosis.