Abstract
BackgroundThe degenerative lumbar spinal stenosis is one of the most commonly treated spinal disorders in older adults; despite its increasing frequency, it is not yet clear what the most effective therapy might be. The aim of this study is to investigate the very long term results of a homogenized cohort of patients suffering from lumbar spinal stenosis: the first subset of patients operated on with laminectomy and the second subset of patients was also advised to undergo laminectomy but never operated on.MethodsPatients from both subgroups were advised to undergo surgery, according to the same criteria, in the period between 2000 and 2010 and were re-evaluated in the period between January and December 2016.ResultsComparing the two subsets of patients, both suffering from clinically relevant LSS, the first subset returns a statistically significant clinical improvement at follow-up. The rate of excellent results decreases over years. Iatrogenic spinal instability incidence was found to be 3.8% in the present cohort.ConclusionsAlthough the improvement of the first postoperative years decreases over time and despite the lack of general consensus, the lack of established shared guidelines and the limitations of this research, the results support the utilisation of surgery for the management of this condition.Level of Evidence3.
Highlights
The degenerative lumbar spinal stenosis (LSS) is one of the most commonly treated spinal disorders in older adults [1–3] and, due to the aging of population, has become a widespread reason to undergo lumbar spinal surgery [1, 4]
High-impact trials [4] and prospective reports [5–9] in the relevant Literature suggest that surgery is the best choice over non-surgical treatments, data about long term follow-up are widely missing [7–9] as well as a precise algorithm concerning the correct choice among the different surgical procedures advocated, over years, for the management of this condition
Participants Of a total of 170 patients operated on for lumbar stenosis and matching the aforementioned inclusion criteria, those who underwent simple laminectomy were 105, but we managed to complete the follow-up only to 78 of them; nine patients were found dead, other four were suffering from senile dementia, eight declared themselves unavailable to make a trip to undergo check-ups and all the remaining for various reasons have untraceable results
Summary
Background and rationale The degenerative lumbar spinal stenosis (LSS) is one of the most commonly treated spinal disorders in older adults [1–3] and, due to the aging of population, has become a widespread reason to undergo lumbar spinal surgery [1, 4]. It causes claudication, back and leg pain. Caruso et al J Orthop Traumatol (2019) 20:6 For this reason, we have decided to retrospectively analyse the experience of the first author of this manuscript to contribute to the research on LSS. The aim of this study is to investigate the very long term results of a homogenized cohort of patients suffering from lumbar spinal stenosis: the first subset of patients operated on with laminectomy and the second subset of patients was advised to undergo laminectomy but never operated on
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