LONG-TERM FOLLOW-UP REVIEW OF PATIENTS WHO UNDERWENT LAMINECTOMY FOR LUMBAR STENOSIS - A PROSPECTIVE-STUDY

Object. Decompressive laminectomy for stenosis is the most common oper ation performed in the lumbar spine in older patients. This prospectiv e study was designed to evaluate long-term results in patients with sy mptomatic lumbar stenosis. Methods. Between January 1984 and January 1 995, 170 patients underwent surgery for lumbar stenosis (86 patients), lumbar stenosis and herniated disc (61 patients), or lateral recess s tenosis (23 patients). The male/female ratio for each group was 43:43, 39:22, and 14:9, respectively. The average age for all groups was 61. 4 years. For patients with lumbar stenosis, the success rate was 88.1% at 6 weeks and 86.7% at 6 months. For patients with lumbar stenosis a nd herniated disc, the success rate was 80% at 6 weeks and 77.6% at 6 months, with no statistically significant difference between the two g roups. For patients with lateral recess stenosis, the success rate was 58.7% at 6 weeks and 63.6% at 6 months; however, the sample was not l arge enough to be statistically significant. One year after surgery a questionnaire was sent to all patients; 163 (95.9%) responded. The suc cess rate in patients with stenosis had declined to 69.6%, which was s ignificant (p = 0.012); the rate for patients with stenosis and hernia ted disc was 77.2%; and that for lateral recess stenosis was 65.2%. An other follow-up questionnaire was sent to patients 1 to 11 years after surgery (average 5.1 years); 146 patients (85.9%) responded, 10 (5.9% ) were deceased, and 14 (8.2%) were lost to follow-up review. At 1 to 11 years the success rate was 70.8% for patients with stenosis, 66.6% for those with stenosis and herniated disc, and 63.6% for those with l ateral recess stenosis. Eleven patients who underwent reoperation were included in the group of patients whose surgeries proved unsuccessful , regardless of their ultimate outcome. There was no statistically sig nificant difference in outcome between 1 year and 1 to 11 years with r espect to stenosis, stenosis with herniated disc, and lateral recess s tenosis. Conclusions. In conclusion, long-term improvement after lamin ectomy was maintained in two-thirds of these patients.