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Improvements in Back and Leg Pain After Minimally Invasive Lumbar Decompression

  • Original Article
  • Published:
HSS Journal ®

Abstract

Background

Few studies have quantified clinical improvement following minimally invasive lumbar decompression based on predominant back pain or leg pain.

Purpose

To quantify improvement in patient-reported outcomes following minimally invasive lumbar decompression and determine the degree of improvement in back pain, leg pain, and disability in patients who present with predominant back pain or predominant leg pain.

Methods

Patients who underwent primary, one-level minimally invasive lumbar decompression for degenerative pathology were retrospectively reviewed. Comparisons of visual analog scale (VAS) back and leg pain scores, Oswestry Disability Index (ODI) scores, and Short Form-12 (SF-12) mental and physical component scores from pre-operative to 6-week, 12-week, 6-month, and 1-year follow-up. Subgroup analyses were performed for patients with predominant back pain or predominant leg pain.

Results

A total of 102 patients were identified. Scores on VAS back and leg pain, ODI, and SF-12 physical component improved from pre-operative to all post-operative time points. After 1 year, patients reported a 2.8-point (47%) reduction in back pain and a 4-point (61.1%) reduction in leg pain scores; 52 patients with predominant back pain and 50 patients with predominant leg pain reported reductions in pain throughout the year following surgery. In both the back and leg pain cohorts, patients experienced reductions in ODI during the first 6 months and throughout 1-year follow-up, respectively. The majority of patients achieved minimum clinically important difference, regardless of predominant symptom.

Conclusions

Patients reported improvements in back and leg pain following minimally invasive lumbar decompression regardless of predominant presenting symptom; however, patients with predominant leg pain may experience greater improvement than those with predominant back pain.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St. Suite #300, Chicago, IL, 60612, USA

    Dustin H. Massel MD, Benjamin C. Mayo MD, Dil V. Patel BS, Daniel D. Bohl MD, MPH, Philip K. Louie MD, Gregory D. Lopez MD & Kern Singh MD

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  1. Dustin H. Massel MD
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Conflict of Interest

Dustin H. Massel, MD, Dil V. Patel, BS, Philip K. Louie, MD, and Gregory D. Lopez, MD, declare that they have no conflicts of interest. Benjamin C. Mayo, MD, and Daniel D. Bohl, MD, MPH, report grants from the Cervical Spine Research Society, outside the submitted work. Kern Singh, MD, reports royalties from Zimmer, Stryker, Pioneer, Lippincott Williams & Wilkins, Thieme, Jaypee Publishing, and Slack Publishing; stock ownership in Avaz Surgical LLC and Vital 5 LLC; board of director membership and a grant from Cervical Spine Research Society; membership on the board of directors of the International Society for the Advancement of Spine Surgery (ISASS), American Academy of Orthopaedic Surgeons, Scoliosis Research Society, and Vertebral Column of the ISASS, all outside the submitted work.

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Massel, D.H., Mayo, B.C., Patel, D.V. et al. Improvements in Back and Leg Pain After Minimally Invasive Lumbar Decompression. HSS Jrnl 16, 62–71 (2020). https://doi.org/10.1007/s11420-018-09661-z

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  • DOI: https://doi.org/10.1007/s11420-018-09661-z

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