Analysis of Early Failures After Lumbar Decompressive Laminectomy for Spinal Stenosis

H. Gordon Deen, Richard S. Zimmerman, Mark K. Lyons, Robert E. Wharen, Ronald Reimer

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

To determine why some patients have no improvement after surgical treatment of lumbar spinal stenosis. We conducted a retrospective study of patients who were referred to our institution between 1990 and 1993 because their symptoms were unchanged or worsened after lumbar decompressive laminectomy. For the 45 study patients (25 women and 20 men; mean age, 70.8 years), preoperative and postoperative clinical status, preoperative and postoperative imaging studies, and operative reports were analyzed. Preoperatively, only 23 patients (51%) had the clinical syndrome of neurogenic claudication, and 15 (33%) had midline low-back pain without a radicular component. Three other patients had peripheral neuropathy, and three had atypical leg pain. Only 10 patients had radiographic evidence of severe lumbar canal stenosis; the others had moderate, mild, or no stenosis. In 10 patients, surgical decompression was inadequate. Only three patients had the triad of neurogenic claudication, radiographically confirmed severe lumbar stenosis, and adequate decompression of the lumbar canal and lateral recesses. The most common pattern in patients with early failure after lumbar laminectomy was the absence of actual neurogenic claudication coupled with the absence of severe stenosis on preoperative imaging studies. The most common technical error was inadequate neural decompression. These data suggest that the outcome may be improved by more careful selection of patients and by performance of an adequate surgical decompression.

Original languageEnglish (US)
Pages (from-to)33-36
Number of pages4
JournalMayo Clinic Proceedings
Volume70
Issue number1
DOIs
StatePublished - 1995

Fingerprint

Spinal Stenosis
Laminectomy
Pathologic Constriction
Surgical Decompression
Decompression
Peripheral Nervous System Diseases
Low Back Pain
Patient Selection
Leg
Retrospective Studies
Pain

Keywords

  • computed tomography
  • CT
  • magnetic resonance imaging
  • MRI

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Deen, H. G., Zimmerman, R. S., Lyons, M. K., Wharen, R. E., & Reimer, R. (1995). Analysis of Early Failures After Lumbar Decompressive Laminectomy for Spinal Stenosis. Mayo Clinic Proceedings, 70(1), 33-36. https://doi.org/10.4065/70.1.33

Analysis of Early Failures After Lumbar Decompressive Laminectomy for Spinal Stenosis. / Deen, H. Gordon; Zimmerman, Richard S.; Lyons, Mark K.; Wharen, Robert E.; Reimer, Ronald.

In: Mayo Clinic Proceedings, Vol. 70, No. 1, 1995, p. 33-36.

Research output: Contribution to journalArticle

Deen, HG, Zimmerman, RS, Lyons, MK, Wharen, RE & Reimer, R 1995, 'Analysis of Early Failures After Lumbar Decompressive Laminectomy for Spinal Stenosis', Mayo Clinic Proceedings, vol. 70, no. 1, pp. 33-36. https://doi.org/10.4065/70.1.33
Deen, H. Gordon ; Zimmerman, Richard S. ; Lyons, Mark K. ; Wharen, Robert E. ; Reimer, Ronald. / Analysis of Early Failures After Lumbar Decompressive Laminectomy for Spinal Stenosis. In: Mayo Clinic Proceedings. 1995 ; Vol. 70, No. 1. pp. 33-36.
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