OUTCOME AFTER LAMINECTOMY FOR LUMBAR SPINAL STENOSIS .1. CLINICAL CORRELATIONS

AU patients who undenwent decompressive lumbar laminectomy in the Wash tenaw County, Michigan metropolitan area during a 7-year period were s tudied for the purpose of defining long-term outcome, clinical correla tions, and the need for subsequent fusion. Outcome was determined by q uestionnaire and physical examination from a cohort of 119 patients wi th an average follow-up evaluation interval of 4.6 years. Patients gra ded their outcome as much improved (37%), somewhat improved (29%), unc hanged (17%), somewhat worse (5%), and much worse (12%) compared to th eir condition before surgery. Poor outcome correlated with the need fo r additional surgery, but there were few additional significant correl ations. No patient had a lumbar fusion during the study interval. The outcome after laminectomy was found to be less favorable than previous ly reported, based on a patient questionnaire administered to an unbia sed patient population. Further randomized, controlled trials are ther efore necessary to determine the efficacy of lumbar fusion as an adjun ct to decompressive lumbar laminectomy.