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Multilevel Decompression Surgery For Degenerative Lumbar Spinal Canal Stenosis Is Similarly Effective With Single-Level Decompression Surgery London Spine

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Published article

CONCLUSIONS: Despite longer surgical time and larger volume of estimated blood loss, multilevel decompression surgery showed similar improvement to that of single-level surgery in terms of recovery of PROs and frequency of revision surgery. Multilevel decompression surgery provides good clinical outcomes with acceptable complication and revision rates when selecting appropriate patient and spinal levels.
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Abstract

Study design: Retrospective case series.

Objective: The purpose of this study was to investigate the outcome of multilevel posterior decompression surgery for degenerative lumbar spinal stenosis (LSS) compared with single-level surgery.

Summary of background data: The clinical outcomes of multilevel decompression surgery are still controversial because previous studies have not been designed to randomize or adjust the patient background.

Methods: A retrospective review of prospectively collected data from 659 surgically treated LSS patients with minimum 2-year follow-up was performed. Among them, we compared baseline and 2-year postoperative patient-reported outcomes (PROs) including VAS and JOABPEQ scores of 122 patients who underwent 3 or more levels of surgery (M group) and 304 patients who underwent single-level surgery (S group). Further analyses were performed of 116 paired patients from both groups who were propensity score matched by age and baseline PROs.

Results: The number of perioperative complications including extradural hematoma, surgical site infection, and spinal fluid leakage (M vs. S: 10 [8%] vs. 19 [6%], P=0.47), and frequency of revision surgery (5 [4%] vs. 23 [8%], P=0.10) were similar between the two groups. In the analysis of propensity score matched patients, there were comparable improvements in the VAS score for lower back pain (2.6 vs. 2.4, P=0.55), buttock-leg pain (3.1 vs. 3.4, P=0.48), and buttock-leg numbness (2.9 vs. 2.9, P=0.77) in both groups. There were also similar improvements in the JOABPEQ scores including lower back pain, lumbar function, walking ability, and mental health domains, except for the social life function domain (20.7±26.5 vs. 28.0±27.5, P=0.04).

Conclusions: Despite longer surgical time and larger volume of estimated blood loss, multilevel decompression surgery showed similar improvement to that of single-level surgery in terms of recovery of PROs and frequency of revision surgery. Multilevel decompression surgery provides good clinical outcomes with acceptable complication and revision rates when selecting appropriate patient and spinal levels.

The London Spine Unit : innovative sugical centre in UK
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Multilevel Decompression Surgery for Degenerative Lumbar Spinal Canal Stenosis is Similarly Effective with Single-level Decompression Surgery

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Abstract Study design: Retrospective case series. Objective: The purpose of this study was to investigate the outcome of multilevel posterior decompression surgery for degenerative lumbar spinal stenosis (LSS) compared with single-level surgery. Summary of background data: The clinical outcomes of multilevel decompression surgery are still controversial because previous studies have not been designed to randomize…

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