European Spine Journal

, Volume 19, Issue 11, pp 1849–1854 | Cite as

Predictors of residual symptoms in lower extremities after decompression surgery on lumbar spinal stenosis

  • Nobuhiro Hara
  • Hiroyuki Oka
  • Takashi Yamazaki
  • Katsushi Takeshita
  • Motoaki Murakami
  • Kazuto Hoshi
  • Sei Terayama
  • Atsushi Seichi
  • Kozo Nakamura
  • Hiroshi Kawaguchi
  • Ko Matsudaira
Original Article

Abstract

Leg pain/numbness and gait disturbance, two major symptoms in the lower extremities of lumbar spinal stenosis (LSS), are generally expected to be alleviated by decompression surgery. However, the paucity of information available to patients before surgery about specific predictors has resulted in some of them being dissatisfied with the surgical outcome when the major symptoms remain after the procedure. This prospective, observational study sought to identify the predictors of the outcome of a decompression surgery: modified fenestration with restorative spinoplasty. Of 109 consecutive LSS patients who underwent the decompression surgery, 89 (56 males and 33 females) completed the 2 year follow-up. Both leg pain/numbness and gait disturbance determined by the Japanese Orthopedic Association scoring system were significantly improved at 2 years after surgery compared to those preoperative, regardless of potential predictors including gender, preoperative presence of resting numbness in the leg, drop foot, cauda equina syndrome, degenerative spinal deformity or myelographic filling defect, or the number of decompressed levels. However, 27 (30.3%) and 13 (14.6%) patients showed residual leg pain/numbness and gait disturbance, respectively. Among the variables examined, the preoperative resting numbness was associated with residual leg pain/numbness and gait disturbance, and the preoperative drop foot was associated with residual gait disturbance, which was confirmed by logistic regression analysis after adjustment for age and gender. This is the first study to identify specific predictors for these two remaining major symptoms of LSS after decompression surgery, and consideration could be given to including this in the informed consent.

Keywords

Lumbar spinal stenosis Decompression surgery Outcome Predictor 

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Nobuhiro Hara
    • 1
  • Hiroyuki Oka
    • 2
  • Takashi Yamazaki
    • 3
  • Katsushi Takeshita
    • 1
  • Motoaki Murakami
    • 3
  • Kazuto Hoshi
    • 1
  • Sei Terayama
    • 1
  • Atsushi Seichi
    • 4
  • Kozo Nakamura
    • 1
  • Hiroshi Kawaguchi
    • 1
  • Ko Matsudaira
    • 5
  1. 1.Departments of Orthopaedic Surgery, Faculty of MedicineThe University of TokyoTokyoJapan
  2. 2.Faculty of Medicine, 22nd Century Medical CenterThe University of TokyoTokyoJapan
  3. 3.Musashino Red Cross HospitalTokyoJapan
  4. 4.Jichi Medical UniversityTochigiJapan
  5. 5.Clinical Research Centre for Occupational Musculoskeletal DisordersKanto Rosai HospitalKawasakiJapan

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