Long-Term Outcomes of Laminectomy in Lumbar Spinal Stenosis: A Systematic Review and Meta-Analysis

Author:

Sajadi Kiavash1,Azarhomayoun Amir1,Jazayeri Seyed Behnam2,Baigi Vali1,Ranjbar Hameghavandi Mohammad Hosein1,Rostamkhani Sabra1,Atlasi Rasha3,Faghih Jooybari Morteza4,Ghodsi Zahra15,Vaccaro Alexander R.6,Khorasanizadeh MirHojjat7,Rahimi-Movaghar Vafa14589

Affiliation:

1. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran

2. Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran

3. Medical Library & Information Science, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

4. Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

5. Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran

6. Department of Orthopedics and Neurosurgery, Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, United States

7. Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States

8. Universal Scientific Education and Research Network (USERN), Tehran, Iran

9. Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran

Abstract

Abstract Objective Lumbar spinal stenosis (LSS) patients suffer from significant pain and disability. To assess long-term safety and efficacy of laminectomy in LSS patients, a systematic review and meta-analysis study was conducted. Methods Literature review in MEDLINE, Embase, Scopus, Web of Science, and Cochrane Library databases was performed using a predefined search strategy. Articles were included if they met the following characteristics: human studies, LSS, and at least 5 years of follow-up. Outcome measures included patient satisfaction, pain, disability, claudication, reoperation rates, and complications. Results Twelve articles met the eligibility criteria for our study. Overall, there was low-quality evidence that patients undergoing laminectomy, with at least 5 years of follow-up, have significantly more satisfaction, and less pain and disability, compared with the preoperative baseline. Assessment of neurogenic intermittent claudication showed significant improvement in walking abilities. We also reviewed the postoperative complication and adverse events in the included studies. After meta-analysis was performed, the reoperation rate was found to be 14% (95% confidence interval: 13–16%). Conclusion Our study provides low-quality evidence suggesting that patients undergoing laminectomy for LSS have less disability and pain and can be more physically active postoperatively.

Publisher

Georg Thieme Verlag KG

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