Clinical and roentgenographic results of decompression for lumbar spinal stenosis

We reviewed 118 patients who underwent lumbar decompression without fusion for acquired lumbar spinal stenosis between 1980 and 1991. Fifty of these patients (15 men, 35 women) were clinically and roentgenographically reexamined, with quantification of postoperative degenerative changes. The presence of preoperative spondylolisthesis and a postoperative change in spondylolisthesis portended poor outcome. Men had better mean surgical outcome scores than did women, and 6% of the men and 28% of the women underwent further surgery for recurrent stenosis or instability. Women had larger mean postoperative changes in spondylolisthesis than did men. Patients with mild preoperative spondylolisthesis developed a larger slip after the procedure than did those with no preoperative slip. Women and patients with preoperative spondylolisthesis may require changes in existing treatment modalities to improve outcome or alterations in long-term expectations after lumbar decompression for stenosis.