Can decompression surgery relieve low back pain in patients with lumbar spinal stenosis combined with degenerative lumbar scoliosis? Tsutsui S, Kagotani R, Yamada H, et al. Eur Spine J 2013 Apr 24. [Epub ahead of print]

Abstract Background Although there are reports on the effectiveness of microendoscopic laminotomy using a spinal endoscope as decompression surgery for lumbar spinal stenosis, predicting the improvement of low back pain (LBP) still poses a challenge, and no clear index has been established. This study aimed to investigate whether microendoscopic laminotomy for lumbar spinal stenosis improves low back pain and determine the preoperative predictors of residual LBP. Methods In this single-center retrospective study, we examined 202 consecutive patients who underwent microendoscopic laminotomy for lumbar spinal stenosis with a preoperative visual analog scale (VAS) score for LBP of ≥40 mm. The lumbar spine Japanese Orthopaedic Association (JOA), and VAS scores for LBP, leg pain (LP), and leg numbness (LN) were examined before and at 1 year after surgery. Patients with a 1-year postoperative LBP-VAS of ≥25 mm composed the residual LBP group. The preoperative predictive factors associated with postoperative residual LBP were analyzed. Results JOA scores improved from 14.1 preoperatively to 20.2 postoperatively (p < 0.001), LBP-VAS improved from 66.7 to 29.7 mm (p < 0.001), LP-VAS improved from 63.8 to 31.2 mm (p < 0.001), and LN-VAS improved from 63.3 to 34.2 mm (p < 0.001). Ninety-eight patients (48.5%) had a postoperative LBP-VAS of ≥25 mm. Multiple logistic regression analysis revealed that Modic type 1 change (odds ratio [OR], 5.61; 95% confidence interval [CI], 1.68–18.68; p = 0.005), preoperative VAS for LBP ≥ 70 mm (OR, 2.19; 95% CI, 1.17–4.08; p = 0.014), and female sex (OR, 1.98; 95% CI, 1.09–3.89; p = 0.047) were preoperative predictors of residual LBP. Conclusion Microendoscopic decompression surgery had an ameliorating effect on LBP in lumbar spinal stenosis. Modic type 1 change, preoperative VAS for LBP, and female sex were predictors of postoperative residual LBP, which may be a useful index for surgical procedure selection.

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Lumbar Scoliosis Combined Lumbar Spinal Stenosis and Herniation Diagnosed Patient Was Treated with “U” Route Transforaminal Percutaneous Endoscopic Lumbar Discectomy

Case Reports in Orthopedics ◽

10.1155/2017/7439016 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Binbin Wu ◽

Shaobo Zhang ◽

Qingquan Lian ◽

Haibo Yan ◽

Xianfa Lin ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Lumbar Discectomy ◽

Low Back ◽

Lumbar Scoliosis ◽

Endoscopic Lumbar Discectomy ◽

Lumbar Spinal

The objective was to report a case of a 63-year-old man with a history of low back pain (LBP) and left leg pain for 2 years, and the symptom became more serious in the past 5 months. The patient was diagnosed with lumbar scoliosis combined with lumbar spinal stenosis (LSS) and lumbar disc herniation (LDH) at the level of L4-5 that was confirmed using Computerized Topography and Magnetic Resonance Imaging. The surgical team preformed a novel technique, “U” route transforaminal percutaneous endoscopic lumbar discectomy (PELD), which led to substantial, long-term success in reduction of pain intensity and disability. After removing the osteophyte mass posterior to the thecal sac at L4-5, the working channel direction was changed to the gap between posterior longitudinal ligament and thecal sac, and we also removed the herniation and osteophyte at L3-4 with “U” route PELD. The patient’s symptoms were improved immediately after the surgical intervention; low back pain intensity decreased from preoperative 9 to postoperative 2 on a visual analog scale (VAS) recorded at 1 month postoperatively. The success of the intervention suggests that “U” route PELD may be a feasible alternative to treat lumbar scoliosis with LSS and LDH patients.

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Clinical and Radiological Study Focused on Relief of Low Back Pain After Decompression Surgery in Selected Patients With Lumbar Spinal Stenosis Associated With Grade I Degenerative Spondylolisthesis

Spine ◽

10.1097/brs.0000000000001813 ◽

2016 ◽

Vol 41 (24) ◽

pp. E1434-E1443 ◽

Cited By ~ 8

Author(s):

Ko Ikuta ◽

Keigo Masuda ◽

Fuyuki Tominaga ◽

Takahide Sakuragi ◽

Kazuhiro Kai ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Degenerative Spondylolisthesis ◽

Decompression Surgery ◽

Low Back ◽

Radiological Study ◽

Lumbar Spinal

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The Effectiveness of Decompression Surgery on Low Back Pain in Patients with Central Lumbar Spinal Stenosis

Journal of Korean Society of Spine Surgery ◽

10.4184/jkss.2021.28.1.13 ◽

2021 ◽

Vol 28 (1) ◽

pp. 13

Author(s):

Sangbong Ko ◽

Jaejun Lee ◽

Junho Nam

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Decompression Surgery ◽

Low Back ◽

Lumbar Spinal

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The Effectiveness of Decompression Surgery on Low Back Pain in Patients with Central Lumbar Spinal Stenosis

10.21203/rs.3.rs-102430/v1 ◽

2020 ◽

Author(s):

Sangbong Ko ◽

Jaejun Lee ◽

Junho Nam

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Lower Leg ◽

Decompression Surgery ◽

Low Back ◽

Lower Limb Pain ◽

Clinically Significant ◽

Lumbar Spinal

Abstract Background: Patients with central lumbar spinal stenosis (CLSS) complain of not only the lower leg symptoms but also low back pain (LBP) simultaneously in many cases. Therefore, patients who undergo decompressive surgery expect recovery from LBP as well as lower leg symptoms, and surgeons who perform decompression surgery are making efforts to improve both symptoms. The objective of this study is to investigate whether decompression surgery can improve low back pain and symptoms of lower limb pain in patients with one level central lumbar spinal stenosis.Methods: The present study included 39 patients who had findings of central lumbar spinal stenosis and underwent decompression surgery due to its corresponding claudication and lower leg radiating pain complaints from 2013 to 2018. Their pain (lower leg radiating pain and low back pain) and functional outcomes (Oswestry Disability Index (ODI), Roland–Morris Disability Questionnaire (RMDQ), and Short Form-36 (SF-36)) were evaluated before surgery and 6 and 12 months after surgery.Results: Mean lower leg radiating pain continuously showed statistically significant improvement (p < 0.05, p = 0.003); however, the clinical significance of differences above minimum clinically important difference (MCID) was up to 6 months. Mean low back pain was 4.72 ± 3.40 before surgery, 2.33 ± 2.27 at 6 months after surgery, and 2.21 ± 2.02 at 12 months after surgery, showing statistically and clinically significant improvement (p < 0.05) up to 6 months after surgery, after which there were no findings of improvement. Conclusion: Decompression surgery for patients with central lumbar spinal stenosis showed clinically significant improvements in lower leg radiating pain and low back pain up to 6 months after surgery and continuous improvements in lower leg radiating pain up to 12 months, but there was no continuous improvement in LBP.

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