Abstract
Background:The objective of this study is to determine the clinical and surgical outcomes following lumbar laminectomy.Methods:We retrospectively reviewed medical records of neurosurgical patients who underwent first-time, bilateral, 1-3 level laminectomies for degenerative lumbar disease. Patients with discectomy, complete facetectomy, and fusion were excluded.Results:Five hundred patients were followed for an average of 46.79 months. Following lumbar laminectomy, patients experienced statistically significant improvement in back pain, neurogenic claudication, radiculopathy, weakness, and sensory deficits. The rate of intraoperative durotomy was 10.00%; however, 1.60% experienced a postoperative cerebrospinal fluid leak. The risk of experiencing at least one postoperative complication with a lumbar laminectomy was 5.60%. Seventy-two patients (14.40%) required reoperations for progression of degenerative disease over a mean of 3.40 years. The most common symptoms prior to reoperation included back pain (54.17%), radiculopathy (47.22%), weakness (18.06%), sensory deficit (15.28%), and neurogenic claudication (19.44%). The relative risk of reoperation for patients with postoperative back pain was 6.14 times higher than those without postoperative back pain (P < 0.001). Of the 72 patients undergoing reoperations, 55.56% underwent decompression alone, while 44.44% underwent decompression and posterolateral fusions. When considering all-time reoperations, the lifetime risk of requiring a fusion after a lumbar laminectomy based on this study (average follow-up of 46.79 months) was 8.0%.Conclusion:Patients experienced statistically significant improvements in back pain, neurogenic claudication, radiculopathy, motor weakness, and sensory deficit following lumbar laminectomy. Incidental durotomy rate was 10.00%. Following a first-time laminectomy, the reoperation rate was 14.4% over a mean of 3.40 years.
Highlights
Lumbar laminectomy continues to be one of the most common lumbar procedures performed for spinal stenosis
Despite the rising cost related to this procedure, most of the current literature on laminectomy focuses on combined procedures including discectomy and/or arthrodesis.[1,7]
We characterized the efficacy/safety, clinical, and surgical outcomes of first‐time, bilateral, 1‐3 level lumbar laminectomy performed for degenerative spinal disease, excluding those undergoing concurrent discectomy and/ or arthrodesis
Summary
Lumbar laminectomy continues to be one of the most common lumbar procedures performed for spinal stenosis. According to the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS), the annual estimate of laminectomy discharges averages around 34 discharges per 100,000 adults from 1998 to 2008.[6] Mean total hospital charges have more than doubled from $14,308 in 1998 to $35,256 in 2008. Despite the rising cost related to this procedure, most of the current literature on laminectomy focuses on combined procedures including discectomy and/or arthrodesis.[1,7] In this study, we characterized the efficacy/safety, clinical, and surgical outcomes of first‐time, bilateral, 1‐3 level lumbar laminectomy performed for degenerative spinal disease, excluding those undergoing concurrent discectomy and/ or arthrodesis. The objective of this study is to determine the clinical and surgical outcomes following lumbar laminectomy
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