The Journal of Bone and Joint Surgery, Vol 73, Issue 6 809-816, Copyright © 1991 by Journal of Bone and Joint Surgery, Inc
The outcome of decompressive laminectomy for degenerative lumbar stenosis
JN Katz, SJ Lipson, MG Larson, JM McInnes, AH Fossel and MH Liang
Brigham and Women's Hospital, Robert B. Brigham Multipurpose Arthritis Center, Boston, Massachusetts 02115.
The outcome of laminectomy for the relief of symptoms resulting from
degenerative lumbar stenosis is not well established. Eighty-eight
consecutive patients who had had a laminectomy for degenerative lumbar
stenosis between 1983 and 1986 were studied. Eight of the patients had had
a concomitant arthrodesis. The follow-up evaluation included a review of
charts and standardized questionnaires that were completed by the patients.
One year postoperatively, five patients (6 per cent) had had a second
operation and five still had severe pain. By the time of the latest
follow-up, in 1989, fifteen (17 per cent) of the original eighty-eight
patients had had a repeat operation because of instability or stenosis;
twenty-one (30 per cent) of the seventy patients who were evaluated by
questionnaire in 1989 had severe pain. The factors found to be associated
with a poor long-term outcome, defined as severe pain or the need for a
repeat operation, or both, included co-existing illnesses (such as
osteoarthrosis, cardiac disease, rheumatoid arthritis, or chronic pulmonary
disease) (p = 0.004), the duration of follow-up (p = 0.01), and an initial
laminectomy involving a single interspace (p = 0.04). We concluded that the
long-term outcome of decompressive laminectomy is less favorable than has
been previously reported, and that co-morbidity and a single-interspace
laminectomy are risk factors for a poor outcome.
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