Outcomes and Patient Satisfaction Following Micro-endoscopic Laminotomy for Lumbar Spinal Stenosis: A Comprehensive...

The aim of this study is to examine how patient-reported satisfaction at one year after micro-endoscopic laminotomy (MEL) for lumbar spinal stenosis (LSS) aligns with conventional outcome measures and to assess whether these instruments adequately reflect patient perspectives.

We conducted a single-center retrospective cohort study of adults undergoing MEL for symptomatic LSS. Patients completed preoperative and one-year postoperative assessments, including visual analogue scales for pain and numbness, the Roland-Morris Disability Questionnaire (RMDQ), the Oswestry Disability Index (ODI), selected Japanese Orthopaedic Association (JOA) items, and the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ). Patient satisfaction was captured by a recommendation-level item at one year. Pre-post changes and associations with satisfaction were analyzed using standard parametric or nonparametric tests as appropriate.

One-year satisfaction was positively associated with postoperative functioning in social and psychological domains and with walking ability and pain-related impairment, and it was inversely associated with residual lower back pain and disability. Numbness showed a weaker association with satisfaction. Although conventional scales documented clinical improvement, they accounted for only part of the variance in satisfaction.

Conventional outcome scores capture important but incomplete aspects of recovery after MEL. Incorporating a brief, patient-reported satisfaction measure alongside established instruments can provide a more balanced appraisal of outcomes and support shared decision-making. Prospective studies are warranted to refine how satisfaction is integrated into routine evaluation.