Lumbar Spinal Stenosis with Degenerative Spondylolisthesis Treated with Decompression Alone. A Cohort of 346 Patients at a Large Spine Unit. Clinical Outcome, Complications and Subsequent Surgery

Spine (Phila Pa 1976). 2022 Mar 15;47(6):470-475. doi: 10.1097/BRS.0000000000004291.


Study design: Cohort study.

Objective: To study the clinical outcome, complications and subsequent surgery rate of DA for lumbar spinal stenosis (LSS) with DS.

Summary of background data: There is still no consensus regarding the treatment approach for LSS with DS.

Methods: We performed a retrospectively designed cohort study on prospectively collected data from a single high productive spine surgical center. Results from the Swedish Spine Registry and a local register for complications were used for the analyses. Patients with LSS and DS (>3 mm) who underwent DA during January 2012 to August 2017 were included. Patient reported outcome measures at baseline and 2 years after surgery were analyzed. Complications within 30 days of surgery and all subsequent surgery in the lumbar spine were registered.

Results: We identified and included 346 patients with completed 2-year follow-up registration. At 2-year follow-up there was a significant improvement in all outcome measures. The global assessment success rate for back and leg pain was 68.3% and 67.6% respectively. Forty-one patients had at least 1 intra- or postoperative complication (11.9%). Nine patients (2.6%), underwent subsequent surgery within 2 years of the primary surgery whereof 2 underwent fusion. During the whole period of data collection, that is, as of June 2020, 28 patients had undergone subsequent surgery (8.1%) whereas 8 of them had had 2 surgeries. Fifteen patients underwent fusion.

Conclusion: DA provides good clinical outcome at 2-year follow-up in patients with LSS and DS with low rate of intra- and postoperative complications and subsequent surgery. Our data supports the evidence that DA is effective and safe for LSS with DS.Level of Evidence: 3.

MeSH terms

  • Cohort Studies
  • Decompression, Surgical / adverse effects
  • Decompression, Surgical / methods
  • Humans
  • Lumbar Vertebrae / surgery
  • Retrospective Studies
  • Spinal Fusion* / adverse effects
  • Spinal Fusion* / methods
  • Spinal Stenosis* / complications
  • Spondylolisthesis* / complications
  • Treatment Outcome