PDF icon Download PDF
J Neurol Surg A Cent Eur Neurosurg 2019; 80(02): 081-087
DOI: 10.1055/s-0038-1669473
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Improvement of Back and Leg Pain after Lumbar Spinal Decompression without Fusion

Matthias Florian Geiger
1   Department of Neurosurgery, Medical Center University of Aachen, RWTH University, Aachen, NRW, Germany
,
Nicola Bongartz
1   Department of Neurosurgery, Medical Center University of Aachen, RWTH University, Aachen, NRW, Germany
,
Christian Blume
1   Department of Neurosurgery, Medical Center University of Aachen, RWTH University, Aachen, NRW, Germany
,
Hans Clusmann
1   Department of Neurosurgery, Medical Center University of Aachen, RWTH University, Aachen, NRW, Germany
,
Christian Andreas Müller
1   Department of Neurosurgery, Medical Center University of Aachen, RWTH University, Aachen, NRW, Germany
› Author Affiliations
Further Information

Publication History

28 February 2018

25 May 2018

Publication Date:
05 December 2018 (online)

Also available ateRefMedOne
  Permissions and Reprints
Preview

Abstract

Background To evaluate whether decompression in lumbar spinal stenosis without fusion leads to sufficient improvement of back pain and leg pain and whether re-decompression alone is sufficient for recurrent lumbar spinal stenosis for patients without signs of instability.

Material and Methods A successive series of 102 patients with lumbar spinal stenosis (with and without previous lumbar surgery) were treated with decompression alone during a 3-year period. Data on pre- and postoperative back pain and leg pain (numerical rating scale [NRS] scale) were retrospectively collected from questionnaires with a return rate of 65% (n = 66). The complete cohort as well as patients with first-time surgery and re-decompression were analyzed separately. Patients were dichotomized to short-term follow-up (< 100 weeks) and long-term follow-up (> 100 weeks) postsurgery.

Results Overall, both back pain (NRS 4.59 postoperative versus 7.89 preoperative; p < 0.0001) and leg pain (NRS 4.09 versus 6.75; p < 0.0001) improved postoperatively. The short-term follow-up subgroup (50%, n = 33) showed a significant reduction in back pain (NRS 4.0 versus 6.88; p < 0.0001) and leg pain (NRS 2.49 versus 6.91: p < 0.0001). Similar results could be observed for the long-term follow-up subgroup (50%, n = 33) with significantly less back pain (NRS 3.94 versus 7.0; p < 0.0001) and leg pain (visual analog scale 3.14 versus 5.39; p < 0.002) postoperatively. Patients with previous decompression surgery benefit significantly regarding back pain (NRS 4.82 versus 7.65; p < 0.0024), especially in the long-term follow-up subgroup (NRS 4.75 versus 7.67; p < 0.0148). There was also a clear trend in favor of leg pain in patients with previous surgery; however, it was not significant.

Conclusions Decompression of lumbar spinal stenosis without fusion led to a significant and similar reduction of back pain and leg pain in a short-term and a long-term follow-up group. Patients without previous surgery benefited significantly better, whereas patients with previous decompression benefited regarding back pain, especially for long-term follow-up with a clear trend in favor of leg pain.

Keywords

lumbar spinal stenosis - decompression - re-decompression - outcome - leg and back pain