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CC BY-NC-ND 4.0 · Asian J Neurosurg 2022; 17(02): 141-155
DOI: 10.1055/s-0042-1756421
Review Article

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

Kiavash Sajadi
1   Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
,
Amir Azarhomayoun
1   Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
,
Seyed Behnam Jazayeri
2   Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
,
Vali Baigi
1   Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
,
Mohammad Hosein Ranjbar Hameghavandi
1   Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
,
Sabra Rostamkhani
1   Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
,
Rasha Atlasi
3   Medical Library & Information Science, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
,
Morteza Faghih Jooybari
4   Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
,
Zahra Ghodsi
1   Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
5   Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
,
Alexander R. Vaccaro
6   Department of Orthopedics and Neurosurgery, Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
MirHojjat Khorasanizadeh
7   Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States
,
Vafa Rahimi-Movaghar
1   Sina Trauma and Surgery Research Center, 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
8   Universal Scientific Education and Research Network (USERN), Tehran, Iran
9   Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
10   Spine Program, University of Toronto, Toronto, Canada
› Author Affiliations Funding This work was funded by Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences [grant number is 94-03-38-30374]. This systematic review is the thesis of the first author for certification of general practice in medicine under supervision of the corresponding author.
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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.

Keywords

laminectomy - spinal stenosis - lumbar spinal stenosis - intermittent claudication

Ethical Approval

The Ethics Committee of Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, approved the study, and the reference number is IR.TUMS.MEDICINE.REC.1397.875.




Publication History

Article published online:
29 August 2022

© 2022. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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