The outcome of spinal decompression surgery 5 years on

Abstract

Decompression surgery is an increasingly common operation for the treatment of lumbar spinal stenosis. Although good relief from leg pain is expected after surgery, long term results of pain relief and function are more uncertain. This study prospectively followed a cohort of patients presenting with the signs and symptoms of spinal stenosis, who underwent decompression surgery to ascertain the long term outcome with respect to pain and function using visual analogue pain scores, the Oswestry Disability Index, and the Short Form 36, a general health questionnaire. From an initial pool of 84 recruited patients, 7 withdrew from surgical intervention; of the remaining 77, 51 (66%) returned for follow up assessments at 5 years. In these responders, a significant improvement was observed in back and leg pain, which was sustained for at least 1 year (P < 0.01). A significant improvement was also seen in physical function (P < 0.05) as assessed by Oswestry and SF-36. Although an initial improvement was noted in social function, this was not observed at 5 years. This study has demonstrated that decompression surgery is successful in relieving symptoms of lumbar spinal stenosis. Physical function, back and leg pain are significantly improved after 5 years but initial significant improvements in social function diminish over time.

Fig. 1

Changes in back and leg pain over 5 years, mean and standard error presented with Student’s t test P values for difference from baseline, n = 72 at baseline, 68 at 6 weeks, 65 at 1 year and 51 at 5 years

Fig. 2

Changes in Oswestry Disability Index score over 5 years, mean and standard error presented with Student’s t test P values for difference from baseline. N = 72 at baseline, 68 at 6 weeks, 65 at 1 year and 51 at 5 years