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Updated: Jun 29, 2026
Three-dimensional Navigation-guided, Prone, Single-position, Lateral Lumbar Interbody Fusion Technique
Published on: July 15, 2021
Interlaminar versus sublaminar lumbar decompression: a retrospective study on patient satisfaction as measured by
Joseph P Cavataio1,2, Nadeed Sadique1,3, Ali Mehaidli1
1Department of Orthopedic Surgery, Henry Ford Health System, Detroit, MI, USA.
Background:
Interlaminar and sublaminar decompressions are evolving alternatives to traditional lumbar laminectomy for managing symptomatic lumbar stenosis, but comparative patient-reported outcomes remain underexplored. This study evaluates differences in Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference and physical function (PF) scores between interlaminar and sublaminar lumbar decompression.
Methods:
We conducted a retrospective cohort study of 74 patients (18-85 years) who underwent lumbar decompression without fusion at a Level I Trauma Center from January 2022 to March 2024. Patients were categorized by decompression type per operative reports. PROMIS pain and PF scores were collected preoperatively and at 2 weeks, 4 weeks, 3 months, 6 months, and 1 year postoperatively. Linear mixed-effects models assessed changes from baseline, adjusting for age, body mass index (BMI), surgical levels, and operative time.
Results:
Sublaminar decompression demonstrated greater improvements from baseline in PROMIS PF scores compared to interlaminar decompression at 2 weeks (mean difference: +7.84), 4 weeks, 3 months, and 6 months. Similarly, PROMIS pain scores improved more in sublaminar patients at 2 weeks and 6 months, with interlaminar patients showing a smaller reduction [mean difference in pain improvement: -4.27; standard error (SE): 1.99; P=0.03]. Absolute PROMIS pain and PF scores, however, did not significantly differ between the two techniques (pain: P=0.93; PF: P=0.23). A significant interaction was observed between BMI and surgical type for pain outcomes: in sublaminar decompression, every 1 kg/m2 increase in BMI above the cohort mean (29.3 kg/m2) was associated with a +0.79-point increase in PROMIS pain score (P=0.002), while interlaminar decompression demonstrated no BMI dependency.
Conclusions:
Sublaminar decompression was associated with greater improvements in PROMIS pain and PF scores compared to interlaminar decompression, although absolute postoperative scores were similar. BMI was a significant modifier of pain outcomes in sublaminar patients. Further prospective studies are warranted to validate these findings.
