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The outcome of spinal decompression surgery 5 years on

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Abstract

Decompression surgery is an increasingly common operation for the treatment of lumbar spinal stenosis. Although good relief from leg pain is expected after surgery, long term results of pain relief and function are more uncertain. This study prospectively followed a cohort of patients presenting with the signs and symptoms of spinal stenosis, who underwent decompression surgery to ascertain the long term outcome with respect to pain and function using visual analogue pain scores, the Oswestry Disability Index, and the Short Form 36, a general health questionnaire. From an initial pool of 84 recruited patients, 7 withdrew from surgical intervention; of the remaining 77, 51 (66%) returned for follow up assessments at 5 years. In these responders, a significant improvement was observed in back and leg pain, which was sustained for at least 1 year (P < 0.01). A significant improvement was also seen in physical function (P < 0.05) as assessed by Oswestry and SF-36. Although an initial improvement was noted in social function, this was not observed at 5 years. This study has demonstrated that decompression surgery is successful in relieving symptoms of lumbar spinal stenosis. Physical function, back and leg pain are significantly improved after 5 years but initial significant improvements in social function diminish over time.

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References

  1. Airaksinen O, Herno A, Kaukanen E, Saari T, Sihvonen T, Suomalainen O (1996) Density of lumbar muscles 4 years after decompressive spinal surgery. Eur Spine J 5:193–197

    Article  PubMed  CAS  Google Scholar 

  2. Airaksinen O, Herno A, Saari T (1994) Surgical treatment of lumbar spinal stenosis: patients’ postoperative disability and working capacity. Eur Spine J 3:261–264

    Article  PubMed  CAS  Google Scholar 

  3. Airaksinen O, Herno A, Turunen V, Saari T, Suomlainen O (1997) Surgical outcome of 438 patients treated surgically for lumbar spinal stenosis. Spine 22:2278–2282

    Article  PubMed  CAS  Google Scholar 

  4. Atlas SJ, Delitto A (2006) Spinal stenosis: surgical versus nonsurgical treatment. Clin Orthop Relat Res 443:198–207

    Article  PubMed  Google Scholar 

  5. Atlas SJ, Keller RB, Robson D, Deyo RA, Singer DE (2000) Surgical and nonsurgical management of lumbar spinal stenosis: four-year outcomes from the maine lumbar spine study. Spine 25:556–562

    Article  PubMed  CAS  Google Scholar 

  6. Atlas SJ, Keller RB, Wu YA, Deyo RA, Singer DE (2005) Long-term outcomes of surgical and nonsurgical management of lumbar spinal stenosis: 8 to 10 year results from the maine lumbar spine study. Spine 30:936–943

    Article  PubMed  Google Scholar 

  7. Brazier JE, Harper R, Jones NM, O’Cathain A, Thomas KJ, Usherwood T, Westlake L (1992) Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ 305:160–164

    PubMed  CAS  Google Scholar 

  8. Ciol MA, Deyo RA, Howell E, Kreif S (1996) An assessment of surgery for spinal stenosis: time trends, geographic variations, complications, and reoperations. J Am Geriatr Soc 44:285–290

    PubMed  CAS  Google Scholar 

  9. Cornefjord M, Byrod G, Brisby H, Rydevik B (2000) A long-term (4- to 12-year) follow-up study of surgical treatment of lumbar spinal stenosis. Eur Spine J 9:563–570

    Article  PubMed  CAS  Google Scholar 

  10. Deyo RA, Bass JE (1989) Lifestyle and low-back pain. The influence of smoking and obesity. Spine 14:501–506

    Article  PubMed  CAS  Google Scholar 

  11. Fairbank JC, Couper J, Davies JB, O’Brien JP (1980) The Oswestry low back pain disability questionnaire. Physiotherapy 66:271–273

    PubMed  CAS  Google Scholar 

  12. Garratt AM, Ruta DA, Abdalla MI, Buckingham JK, Russell IT (1993) The SF36 health survey questionnaire: an outcome measure suitable for routine use within the NHS? BMJ 306:1440–1444

    Article  PubMed  CAS  Google Scholar 

  13. Gibson JN, Grant IC, Waddell G (1999) The Cochrane review of surgery for lumbar disc prolapse and degenerative lumbar spondylosis. Spine 24:1820–1832

    Article  PubMed  CAS  Google Scholar 

  14. Gibson JN, Waddell G (2005) Surgery for degenerative lumbar spondylosis: updated Cochrane review. Spine 30:2312–2320

    Article  PubMed  Google Scholar 

  15. Herkowitz HN, Kurz LT (1991) Degenerative lumbar spondylolisthesis with spinal stenosis. A prospective study comparing decompression with decompression and intertransverse process arthrodesis. J Bone Joint Surg Am 73:802–808

    PubMed  CAS  Google Scholar 

  16. Hides JA, Stokes MJ, Saide M, Jull GA, Cooper DH (1994) Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute low back pain. Spine 19:165–172

    Article  PubMed  CAS  Google Scholar 

  17. Iguchi T, Kurihara A, Nakayama J, Sato K, Kurosaka M, Yamasaki K (2000) Minimum 10-year outcome of decompressive laminectomy for degenerative lumbar spinal stenosis. Spine 25:1754–1759

    Article  PubMed  CAS  Google Scholar 

  18. Jarvik JG, Hollingworth W, Heagerty PJ, Haynor DR, Boyko EJ, Deyo RA (2005) Three-year incidence of low back pain in an initially asymptomatic cohort: clinical and imaging risk factors. Spine 30:1541–1548

    Article  PubMed  Google Scholar 

  19. Johnsson KE, Rosen I, Uden A (1992) The natural course of lumbar spinal stenosis. Clin Orthop Relat Res 279:82–86

    PubMed  Google Scholar 

  20. Kaila-Kangas L, Leino-Arjas P, Riihimaki H, Luukkonen R, Kirjonen J (2003) Smoking and overweight as predictors of hospitalization for back disorders. Spine 28:1860–1868

    Article  PubMed  Google Scholar 

  21. Katz JN (1995) Lumbar spinal fusion. Surgical rates, costs, and complications. Spine 20:78S–83S

    Article  PubMed  CAS  Google Scholar 

  22. Katz JN, Stucki G, Lipson SJ, Fossel AH, Grobler LJ, Weinstein JN (1999) Predictors of surgical outcome in degenerative lumbar spinal stenosis. Spine 24:2229–2233

    Article  PubMed  CAS  Google Scholar 

  23. Kawaguchi Y, Matsui H, Tsuji H (1994) Back muscle injury after posterior lumbar spine surgery. Part 2: histologic and histochemical analyses in humans. Spine 19:2598–2602

    Article  PubMed  CAS  Google Scholar 

  24. Levy HI, Hanscom B, Boden SD (2002) Three-question depression screener used for lumbar disc herniations and spinal stenosis. Spine 27:1232–1237

    Article  PubMed  Google Scholar 

  25. Luoto S, Taimela S, Hurri H, Aalto H, Pyykko I, Alaranta H (1996) Psychomotor speed and postural control in chronic low back pain patients. A controlled follow-up study. Spine 21:2621–2627

    Article  PubMed  CAS  Google Scholar 

  26. Malmivaara A, Slatis P, Heliovaara M, Sainio P, Kinnunen H, Kankare J, in-Hirvonen N, Seitsalo S, Herno A, Kortekangas P, Niinimaki T, Ronty H, Tallroth K, Turunen V, Knekt P, Harkanen T, Hurri H (2007) Surgical or nonoperative treatment for lumbar spinal stenosis? A randomized controlled trial. Spine 32:1–8

    Article  PubMed  Google Scholar 

  27. Mariconda M, Fava R, Gatto A, Longo C, Milano C (2002) Unilateral laminectomy for bilateral decompression of lumbar spinal stenosis: a prospective comparative study with conservatively treated patients. J Spinal Disord Tech 15:39–46

    PubMed  Google Scholar 

  28. McGregor AH, Burton AK, Sell P, Waddell G (2006) The development of an evidence-based patient booklet for patients undergoing lumbar discectomy and un-instrumented decompression. Eur Spine J 16(3):339–346

    Article  PubMed  Google Scholar 

  29. McGregor AH, Dicken B, Jamrozik K (2006) National audit of post-operative management in spinal surgery. BMC Musculoskelet Disord 7:47

    Article  PubMed  Google Scholar 

  30. McGregor AH, Hughes SP (2002) The evaluation of the surgical management of nerve root compression in patients with low back pain: Part 1: the assessment of outcome. Spine 27:1465–1470

    Article  PubMed  Google Scholar 

  31. McGregor AH, Hughes SP (2002) The evaluation of the surgical management of nerve root compression in patients with low back pain: Part 2: patient expectations and satisfaction. Spine 27:1471–1476

    Article  PubMed  Google Scholar 

  32. Ohnmeiss DD (2000) Repeatability of pain drawings in a low back pain population. Spine 25:980–988

    Article  PubMed  CAS  Google Scholar 

  33. Rantanen J, Hurme M, Falck B, Alaranta H, Nykvist F, Lehto M, Einola S, Kalimo H (1993) The lumbar multifidus muscle five years after surgery for a lumbar intervertebral disc herniation. Spine 18:568–574

    Article  PubMed  CAS  Google Scholar 

  34. Roh JS, Teng AL, Yoo JU, Davis J, Furey C, Bohlman HH (2005) Degenerative disorders of the lumbar and cervical spine. Orthop Clin North Am 36:255–262

    Article  PubMed  Google Scholar 

  35. Scholz M, Firsching R, Lanksch WR (1998) Long-term follow up in lumbar spinal stenosis. Spinal Cord 36:200–204

    Article  PubMed  CAS  Google Scholar 

  36. Shao Z, Rompe G, Schiltenwolf M (2002) Radiographic changes in the lumbar intervertebral discs and lumbar vertebrae with age. Spine 27:263–268

    Article  PubMed  Google Scholar 

  37. Simotas AC, Dorey FJ, Hansraj KK, Cammisa F Jr (2000) Nonoperative treatment for lumbar spinal stenosis. Clinical and outcome results and a 3-year survivorship analysis. Spine 25:197–203

    Article  PubMed  CAS  Google Scholar 

  38. Sinikallio S, Aalto T, Airaksinen O, Herno A, Kroger H, Savolainen S, Turunen V, Viinamaki H (2006) Depression and associated factors in patients with lumbar spinal stenosis. Disabil Rehabil 28:415–422

    Article  PubMed  Google Scholar 

  39. Taylor H, McGregor AH, Medhi-Zadeh S, Richards S, Kahn N, Zadeh JA, Hughes SP (2002) The impact of self-retaining retractors on the paraspinal muscles during posterior spinal surgery. Spine 27:2758–2762

    Article  PubMed  Google Scholar 

  40. Turner JA, Ersek M, Herron L, Deyo R (1992) Surgery for lumbar spinal stenosis. Attempted meta-analysis of the literature. Spine 17:1–8

    Article  PubMed  CAS  Google Scholar 

  41. Weber H (1983) Lumbar disc herniation. A controlled, prospective study with ten years of observation. Spine 8:131–140

    Article  PubMed  CAS  Google Scholar 

  42. Yamashita K, Ohzono K, Hiroshima K (2006) Five-year outcomes of surgical treatment for degenerative lumbar spinal stenosis: a prospective observational study of symptom severity at standard intervals after surgery. Spine 31:1484–1490

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Biodynamics Laboratory, Biosurgery & Surgical Technology, Division of Surgery, Oncology, Reproductive Biology & Anaesthetics (SORA), Faculty of Medicine, Imperial College London, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK

    N. K. Anjarwalla, L. C. Brown & A. H. McGregor

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  1. N. K. Anjarwalla
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  2. L. C. Brown
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  3. A. H. McGregor
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Correspondence to A. H. McGregor.

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Anjarwalla, N.K., Brown, L.C. & McGregor, A.H. The outcome of spinal decompression surgery 5 years on. Eur Spine J 16, 1842–1847 (2007). https://doi.org/10.1007/s00586-007-0393-z

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  • DOI: https://doi.org/10.1007/s00586-007-0393-z

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