Predictors of residual low back pain after laminectomy for degenerative lumbar stenosis / 中国矫形外科杂志

ABSTRACT

[Objective]To detect the predictors of residual low back pain (LBP) after laminectomy.[Method]From 1996 to 2000,69 cases (31 males and 38 females) of degenerative lumbar stenosis who had underwent laminectomy treatment and with at least 5 years' follow-up documents were involved in this study.LBP were evaluated by the Japan Orthopedic Association (JOA) Scoring System (3 points) pre- and post operation.The relationship between the patients' outcomes and all these clinical and radiographic parameters were analyzed by software package SPSS 13.0.[Result]Twenty-two cases were classified as residual LBP group(group 1) and 47 cases as no-residual LBP group(group 2),binary logistic regression analysis indicated that the predictors of residual LBP were preoperative lumbar lordosis angle、ROM and the number of decompressed laminae.The forward comparison revealed that the lumbar lordosis (22.27??3.12?) and ROM (22.91??2.31?) in group 2 were lower than the lordosis angle (37.23??2.19?) and ROM (31.66??1.52?) in group 1,but the number of decompressed laminae of group 2 (2.77?0.19 ) were higher than that in group 1(1.70?0.10 ) significantly,the P values were 0.000、0.002 and 0.000 respectively.[Conclusion]Residual LBP may attribute to the decrease of compensation ability to the postoperative instable tendency on a more flat and inflexible lumbar spine especially for multi-laminectomy,so that more attention should be paid to these kind of patients to avoid the development of refractory residual LBP.