Mj. Javid et Ej. Hadar, LONG-TERM FOLLOW-UP REVIEW OF PATIENTS WHO UNDERWENT LAMINECTOMY FOR LUMBAR STENOSIS - A PROSPECTIVE-STUDY, Journal of neurosurgery, 89(1), 1998, pp. 1-7
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.