Progression of Lumbar Spine Degeneration After Laminectomy

Lumbar canal stenosis (LCS) is a common degenerative lumbar spinal disease (DLSD) widely treated by decompression surgery, also known as laminectomy. Few cases have been observed where DLSD has progressed postoperatively, thus requiring reoperation. However, data on such cases are limited.

We included 247 patients (148 men and 99 women; mean age = 73.3 years) with a mean follow-up of 2.3 years in this single-center retrospective study. Among them, 129 patients underwent bilateral partial laminectomy (BPL), 91 patients underwent lumbar spinous process-splitting laminectomy (LSPSL), and 27 underwent microendoscopic laminotomy (MEL).

Of all the patients, 34 (13.8%) exhibited progression of lumbar spine degeneration symptoms, with nine (3.6%) requiring reoperation. Over 90% of new symptoms developed within one year of the initial surgery. Reoperation rates were significantly higher in patients with foraminal stenosis (P = <0.001). Additionally, 35 patients (14.2%) exhibited slippage progression. LSPSL resulted in significantly less slippage progression (P = 0.026). Spinal canal and foraminal stenosis were significantly associated with slippage progression (P< 0.001 and P = 0.010, respectively).

LSPSL reduced the incidence of canal and foraminal stenosis. Symptomatic DLSD was more common within one year post surgery, with foraminal stenosis more frequently requiring reoperation.