CLINICAL AND ROENTGENOGRAPHIC RESULTS OF DECOMPRESSION FOR LUMBAR SPINAL STENOSIS

We reviewed 118 patients who underwent lumbar decompression without fu sion for acquired lumbar spinal stenosis between 1980 and 199 1. Fifty of these patients (15 men, 35 women) were clinically and roentgenogra phically reexamined, with quantification of postoperative degenerative changes. The presence of preoperative spondylolisthesis and a postope rative change in spondylolisthesis portended poor outcome. Men had bet ter mean surgical outcome scores than did women, and 6% of the men and 28% of the women underwent further surgery for recurrent stenosis or instability. Women had larger mean postoperative changes in spondyloli sthesis than did men. Patients with mild preoperative spondylolisthesi s developed a larger slip after the procedure than did those with no p reoperative slip. Women and patients with preoperative spondylolisthes is may require changes in existing treatment modalities to improve out come or alterations in long-term expectations after lumbar decompressi on for stenosis.