OUTCOME AFTER LAMINECTOMY FOR LUMBAR SPINAL STENOSIS .2. RADIOGRAPHICCHANGES AND CLINICAL CORRELATIONS

The pre- and postoperative lumbar spine radiographs of 119 patients wh o underwent decompressive lumbar laminectomy were studied to evaluate radiographic changes and to correlate them with clinical outcome. An a ccurate and reproducible method was used for measuring pre- and postop erative radiographs that were separated by an average interval of 4.6 years. Levels of the spine that underwent laminectomy showed greater c hange in spondylolisthesis, disc space angle, and disc space height th an unoperated levels. Outcome correlated with radiographic changes at operated and unoperated levels. This study demonstrates that radiograp hic changes are greater at operated than at unoperated levels and that some postoperative symptoms do correlate with these changes. Lumbar f usion should be considered in some patients who undergo decompressive laminectomy. The efficacy of and unequivocal indications for lumbar fu sion can only be determined from randomized, prospective, controlled t rials, however, and these studies have not yet been undertaken.