Lumbar spinal stenosis. Clinical features, diagnostic procedures, and results of surgical treatment in 68 patients

Abstract

Our experience with 68 patients with strictly defined, myelographically proven, surgically confirmed lumbar spinal stenosis seen over a 30-month period was reviewed. Pseudoclaudication was the commonest symptom (94%) and was described by patients as pain (93%), numbness (63%), or weakness (43%). Symptoms were frequently bilateral (68%) and generally relieved by flexing the lumbosacral spine. Neurologic abnormalities were found in a minority of patients and were usually mild. Electromyography showed one or more lumbosacral radiculopathies in 34 of 37 patients examined. Radiographic evidence of degenerative disk or joint disease was found in 63 patients. All patients had stenosis on myelography, with narrowing at L2, L3, and L4 being the commonest; 30% had multi-level stenosis. Two of ten computed tomograms were normal. Surgery was extensive; 72% of patients had three or more laminae removed. At a mean of 4 years after surgery, 84% of patients reported that surgery had yielded good to excellent results.