• J Orthop Sci · Jul 2017

    A prospective study of recovery from leg numbness following decompression surgery for lumbar spinal stenosis.

    • Hiroki Oba, Takahiro Tsutsumimoto, Mutsuki Yui, Takayuki Kamanaka, Hiroshi Ohta, Hidemi Kosaku, and Hiromichi Misawa.
    • Department of Orthopaedic Surgery, Shinshu University, School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
    • J Orthop Sci. 2017 Jul 1; 22 (4): 670-675.

    BackgroundResidual leg numbness (LN) following lumbar surgery can lower patient satisfaction; however, prospective studies are sparse. The purpose of this study was to evaluate recovery from LN following decompression surgery for lumbar spinal stenosis (LSS).MethodsA total of 145 patients with LSS were enrolled. All patients underwent decompressive surgery, with or without spinal fusion, followed by a 12 month prospective follow-up. The degree of LN and leg pain (LP) was assessed using the visual analog scale (VAS), a patient-reported outcome measure.ResultsSix patients dropped out, and we evaluated 139 patients (average age, 68.1 years). The average VAS-LN scores were 5.9 ± 2.6, 1.8 ± 2.3, 2.0 ± 2.5, 2.1 ± 2.6, 2.2 ± 2.5, and 2.1 ± 2.6, and the average VAS-LP scores were 5.7 ± 2.8, 1.2 ± 1.7, 0.9 ± 1.5, 1.4 ± 2.0, 1.4 ± 2.0, and 1.4 ± 1.9 preoperatively and at 2 weeks, 3, 6, 9, 12 months following the surgery, respectively. Significant improvement in VAS-LN and VAS-LP scores was observed during the first 2 weeks after the surgery. At 12 months after the surgery, the VAS-LN score was significantly greater than the VAS-LP score. The change in the VAS-LN score between the preoperative and 12 month-postoperative values was significantly smaller than that in the VAS-LP score. Multivariate logistic analyses revealed that preoperative symptom duration and preoperative dural sac cross-sectional area (DCSA) were the significant independent predictive factors for residual LN.ConclusionsFollowing lumbar decompression surgery, LN improved significantly during the first 2 weeks after surgery. However, the improvement in the VAS-LN score was less than in the VAS-LP score. Patients with longer preoperative symptom duration and narrow preoperative DCSA showed less LN improvement.Level Of EvidenceLevel 3.Copyright © 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

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