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66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

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Improvement of back and leg pain after lumbar spinal decompression without fusion – comparison of two patient groups with short-term and long-term follow-up

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  • Matthias Geiger - Klinik für Neurochirurgie, RWTH Aachen University, Aachen
  • Nicola Bongartz - Klinik für Neurochirurgie, RWTH Aachen University, Aachen
  • Hans Clusmann - Klinik für Neurochirurgie, RWTH Aachen University, Aachen
  • Christian Andreas Mueller - Klinik für Neurochirurgie, RWTH Aachen University, Aachen

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocP 091

doi: 10.3205/15dgnc489, urn:nbn:de:0183-15dgnc4890

Published: June 2, 2015

© 2015 Geiger et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: To evaluate whether decompression of lumbar spinal stenosis without fusion leads to sufficient loss of back pain (bp) and leg pain (lp) during short-term and long-term follow-up.

Method: 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 (VAS scale) were retrospectively collected from questionnaires with a return rate of 55% (n=55). Patients were dichotomized to short-term follow-up (stfu<100 weeks) and long-term follow-up (ltfu>100 weeks) post surgery.

Results: The mean time between surgery and survey was 100 weeks (SD ± 31). 55 patients (mean age 68 years, 45% female) were included. Overall, both bp (VAS 2.4 postop vs. 4.1 preop p<0.0001) and lp (VAS 2.1 vs. 3.4, p<0.0001) improved postoperatively. The stfu subgroup (45%, range 35.3 to 94.3 weeks) showed a significant reduction in bp (VAS 2.5 vs. 4.2, p<0.0004) and lp (VAS 2.6 vs. 3.7, p<0.0426). Similar results could be observed for the ltfu subgroup (55%, range 102 to 146.9 weeks) with significantly less bp (VAS 2.5 vs. 4.1, p<0.0001) and lp (VAS 1.4 vs. 3.2, p<0.0025) postoperatively. A subgroup of 14 patients with previous lumbar decompression (25%) did not benefit significantly regarding bp and lp, neither in the stfu nor in the ltfu subgroups. The overall mean VAS decrease of bp was 41%, compared to 38% for lp (ns). Preop VAS values for bp were generally about 20% (13-28%) higher than for lp.

Conclusions: Decompression of lumbar spinal stenosis without fusion lead 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 did not benefit regarding bp and lp in general.