Long-Term Clinical Outcome and Reoperation Rate for Microsurgical Bilateral Decompression via Unilateral Approach of Lumbar Spinal Stenosis

Abstract

Objective: To evaluate long-term outcome and reoperation rate for microsurgical bilateral decompression via unilateral approach of lumbar spinal stenosis, a common degenerative spinal disease of the lumbar spine. Methods: In this observational prospective study, 918 patients were treated for single-level or multilevel lumbar spinal stenosis by bilateral decompression via unilateral approach between January 2002 and January 2016. Of 918 patients, 180 underwent microdiscectomy with decompression. Follow-up consisted of radiologic investigations, Oswestry Disability Index questionnaire, and 36-Item Short-Form Health Survey at 6 and 12 months postoperatively. Results: There were 492 female patients (53.6%) and 426 male patients (46.4%) with a mean age of 63.83 ± 10.16 years (range, 43–79 years). Symptom duration was 4–49 months. Average follow-up time was 98 months (range, 25–168 months), and reoperation rate was 2.5%. Oswestry Disability Index scores decreased significantly (from 30.65 ± 7.82 to 11.32 ± 2.50 at 6 months and 11.30 ± 2.49 at 12 months), and 36-Item Short-Form Health Survey parameter scores demonstrated a significant improvement in the early and late follow-up results. Conclusions: Bilateral decompression via unilateral approach for lumbar spinal stenosis allowed a sufficient and safe decompression of the neural structures, resulting in a highly significant reduction of symptoms and disability, acceptable reoperation rate, and improved health-related quality of life. © 2019 Elsevier B.V., All rights reserved.