7- TO 10-YEAR OUTCOME OF DECOMPRESSIVE SURGERY FOR DEGENERATIVE LUMBAR SPINAL STENOSIS

Study Design. Retrospective review and prospective follow-up of 88 pat ients who had decompressive laminectomy with or without fusion from 19 83 to 1986. Objective. To determine the 7- to 10-year outcome of surge ry for degenerative lumbar spinal stenosis. Summary of Background Data , There is limited information on the impact of surgery for lumbar spi nal stenosis on symptoms, walking ability, and satisfaction, as well a s 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 y ears after surgery were evaluated in univariate and multivariate analy ses. 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 foll ow-up. Fifty-five patients answered questionnaires. Average duration o f 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, an d 75% were satisfied with the results of surgery. The severity of curr ent spine-related symptoms was a stronger correlate of physical functi onal status at the time of follow-up than age or nonspinal comorbid co nditions. Conclusions. Seven to 10 years after decompressive surgery f or spinal stenosis, 23% of patients had undergone reoperation and 33% of respondents had severe back pain. Despite a high prevalence of nons pinal problems in this elderly cohort, spinal symptoms were the most i mportant correlate of reduced functional status.