Changes of Clinical Outcomes after Decompression and Fusion for Spinal Stenosis during 2-Year Follow-up Periods

Abstract

Study Design: A prospective study Objective: To assess the clinical outcomes after the surgical treatment of spinal stenosis, using patient-centered measurements at the serial follow-up times. Summary of Literature Review: Patient-centered measurements are appropriate to assess the clinical outcomes of surgery for spinal stenosis. Materials and Methods: Thirty-seven patients underwent posterior decompression and posterolateral fusion, with an iliac autograft using pedicle screw instrumentation. They were assessed for their pain using a visual analog scale, and the Oswestry disability index for the preoperative functional disability, at 6 weeks, 3 and 6 months, and at 1 and 2 years, postoperatively. Results: The pain, as measured by the visual analog scale, was 7.42 points before the operation, and 4.12 and 2.76 six weeks and 1 year after the operation, respectively. Compared with the pre-operation scores, 44% has improved after 6 weeks, and 73% after a year. The functional disability, as measured by the Oswestry disability index, was 56.5% before the operation, and 32.13 and 20.1% three months and 1 year after the operation. Compared with the pre-operation, 43% recovered after 3 months, and 65% after a year. The state of recovery state in the functional disability continued for 2 years after the operation. The disability recovered more slowly than the pain. Conclusions: Patient-centered measurements were found to be appropriate for assessing the clinical outcomes to surgery for spinal stenosis. After decompression and fusion for spinal stenosis, the pain and functional disability both improved for 1 year after the operation, with no worsening in the postoperative improvements at 2 years.