Clinical outcomes after microendoscopic laminotomy for lumbar spinal stenosis: a 5-year follow-up study

• Published in: European spine journal Vol. 24; no. 2; pp. 396 - 403
• Main Authors: Minamide, Akihito, Yoshida, Munehito, Yamada, Hiroshi, Nakagawa, Yukihiro, Hashizume, Hiroshi, Iwasaki, Hiroshi, Tsutsui, Shunji
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2015; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Clinical outcomes; Comorbidity; Endoscopy - methods; Female; Follow-Up Studies; Humans; Joint Instability - surgery; Laminectomy - adverse effects; Laminectomy - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Neurosurgery; Original Article; Prospective Studies; Spinal Stenosis - epidemiology; Spinal Stenosis - surgery; Spondylolisthesis - epidemiology; Surgical Orthopedics; Treatment Outcome; Clinical outcome; Endoscopic surgery; Minimally invasive surgery; Degenerative spondylolisthesis; Lumbar spinal stenosis
• ISSN: 0940-6719; 1432-0932
• DOI: 10.1007/s00586-014-3599-x

Purpose To prospectively investigate the long-term clinical outcomes of microendoscopic laminotomy (MEL) in patients with lumbar spinal stenosis (LSS) with and without degenerative spondylolisthesis (DS). Methods In total, 159 patients (mean age, 68 years) who had undergone MEL for single-level LSS at L4/5 at our institute were recruited and followed-up for 5 years. Patients with and without DS were assigned to the DS ( n  = 71) and control ( n  = 88) groups, respectively. In addition to slippage rate, Japanese orthopedic association (JOA), recovery rate, short-form 36 (SF-36), and Roland–Morris disability questionnaire (RDQ) values were evaluated preoperatively and 5 years postoperatively. All parameters were analyzed by Student’s t test, with p  < 0.05 considered statistically significant. Results Of 159 patients, 12 were lost to follow-up (follow-up rate, 92.5 %); moreover, 15 patients were excluded because of death, cerebral infarction, dementia, or terminal cancer. Thus, 132 patients (DS group: 61, control group: 71) were finally examined. No significant differences were found in preoperative JOA, JOA recovery rate, RDQ, and SF-36 values between groups. The slippage rate in the DS group was 18.1 % preoperatively and 16.8 % at 5 years postoperatively ( p  > 0.05). There was no significant increase in instability in those with DS following MEL. Progressive spinal instability was noted in six patients (9.8 %) and five patients (7.0 %) in the DS and control groups, respectively ( p  > 0.05). Moreover, the success rate of MEL was good/excellent in 70 %, fair in 20 %, and poor in 10 % of patients in both groups. Conclusion MEL showed similar outcomes in patients with DS and in those without DS.