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Assessment of bladder function after lumbar decompressive laminectomy for spinal stenosis: a prospective study
H G Deen1, R S Zimmerman, S K Swanson
1Section of Neurologic Surgery, Mayo Clinic Scottsdale, Arizona.
Journal of Neurosurgery
|June 1, 1994
Summary
Lumbar decompressive laminectomy improved bladder function in 60% of patients with severe spinal stenosis. Postvoiding residual urine volume showed the most significant improvement after surgery.
Area of Science:
- Neurosurgery
- Urology
- Geriatrics
Background:
- Lumbar spinal stenosis is prevalent in elderly individuals, often causing leg pain and bladder dysfunction.
- While laminectomy aims to relieve leg symptoms, its impact on urological function is not fully understood.
Purpose of the Study:
- To prospectively investigate the effect of lumbar decompressive laminectomy on bladder function in patients with severe lumbar spinal stenosis.
Main Methods:
- 20 patients with severe lumbar spinal stenosis and bladder dysfunction underwent cystoscopy and preoperative urodynamic testing.
- A standard decompressive laminectomy was performed.
- Urodynamic studies were repeated at 2 and 6 months postoperatively.
Main Results:
- 60% of patients reported subjective improvement in bladder function at 6 months.
- Postvoiding residual urine volume improved in all patients with elevated baseline levels (45% of cohort).
- Maximum urine flow rates improved; cytometrography, electromyography, and bladder capacity remained unchanged.
Conclusions:
- Lumbar decompressive laminectomy offers a beneficial effect on bladder function for a significant portion of patients with advanced lumbar spinal stenosis.
- Postvoiding residual urine volume is a key indicator of potential improvement.