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. 2015 May 7;6(Suppl 4):S190-3.
doi: 10.4103/2152-7806.156578. eCollection 2015.

Clinical and surgical outcomes after lumbar laminectomy: An analysis of 500 patients

Mohamad Bydon  1 , Mohamed Macki  1 , Nicholas B Abt  1 , Daniel M Sciubba  2 , Jean-Paul Wolinsky  2 , Timothy F Witham  2 , Ziya L Gokaslan  1 , Ali Bydon  1
Affiliations

Clinical and surgical outcomes after lumbar laminectomy: An analysis of 500 patients

Mohamad Bydon et al. Surg Neurol Int. .

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.

Keywords: Fusion; laminectomy; lumbar; outcomes; reoperation; spine.

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Figures

Figure 1
Figure 1
Preoperative symptoms versus postoperative symptoms in 500 patients who underwent first-time bilateral, lumbar laminectomy
Figure 2
Figure 2
Kaplan–Meier curve illustrating time to reoperation for progression of degenerative disease in 500 patients who underwent first-time lumbar laminectomy. Calculated as a function of person-time, the annualized incidence rate of reoperation was 4.6% (IR=0.046 person-years)
Figure 3
Figure 3
Postoperative symptoms following a first-time, bilateral lumbar laminectomy are illustrated for 72 patients who developed progression of degenerative disease that required reoperation
See this image and copyright information in PMC

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