Abstract
Background To evaluate whether decompression in lumbar spinal stenosis without fusion leads
to sufficient improvement of back pain and leg pain and whether re-decompression alone
is sufficient for recurrent lumbar spinal stenosis for patients without signs of instability.
Material and Methods A successive series of 102 patients with lumbar spinal stenosis (with and without
previous lumbar surgery) were treated with decompression alone during a 3-year period.
Data on pre- and postoperative back pain and leg pain (numerical rating scale [NRS]
scale) were retrospectively collected from questionnaires with a return rate of 65%
(n = 66). The complete cohort as well as patients with first-time surgery and re-decompression
were analyzed separately. Patients were dichotomized to short-term follow-up (< 100
weeks) and long-term follow-up (> 100 weeks) postsurgery.
Results Overall, both back pain (NRS 4.59 postoperative versus 7.89 preoperative; p < 0.0001) and leg pain (NRS 4.09 versus 6.75; p < 0.0001) improved postoperatively. The short-term follow-up subgroup (50%, n = 33) showed a significant reduction in back pain (NRS 4.0 versus 6.88; p < 0.0001) and leg pain (NRS 2.49 versus 6.91: p < 0.0001). Similar results could be observed for the long-term follow-up subgroup
(50%, n = 33) with significantly less back pain (NRS 3.94 versus 7.0; p < 0.0001) and leg pain (visual analog scale 3.14 versus 5.39; p < 0.002) postoperatively. Patients with previous decompression surgery benefit significantly
regarding back pain (NRS 4.82 versus 7.65; p < 0.0024), especially in the long-term follow-up subgroup (NRS 4.75 versus 7.67;
p < 0.0148). There was also a clear trend in favor of leg pain in patients with previous
surgery; however, it was not significant.
Conclusions Decompression of lumbar spinal stenosis without fusion led to a significant and similar
reduction of back pain and leg pain in a short-term and a long-term follow-up group.
Patients without previous surgery benefited significantly better, whereas patients
with previous decompression benefited regarding back pain, especially for long-term
follow-up with a clear trend in favor of leg pain.
Keywords
lumbar spinal stenosis - decompression - re-decompression - outcome - leg and back
pain
