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Clinical Classification of Patients With Lumbar Spinal Stenosis Based on Their Leg Pain Syndrome: Its Correlation With 2-Year Surgical Outcome

Yamashita, Kazuo MD*; Aono, Hiroyuki MD; Yamasaki, Ryoji MD

doi: 10.1097/01.brs.0000261031.10091.f5
Clinical Case Series

Study Design. Prospective follow-up and retrospective review of 174 patients surgically treated for degenerative lumbar spinal stenosis.

Objective. To examine whether the type of leg pain syndrome associated with lumbar spinal stenosis is correlated with outcome.

Summary of Background Data. Although classifying patients based on their leg pain syndrome is useful in planning surgical decompression, there is no validated method of classification and its prognostic significance remains unknown.

Methods. Based on the type of leg pain, the patients were classified into 2 groups: unilateral and bilateral. Improvement in functional status was evaluated using the Quebec Back Pain Disability Scale; the symptoms were rated on a visual analog scale and the change from baseline to 2-year evaluation was noted. Associations between score changes and baseline variables were examined using multivariate analysis.

Results. The type of leg pain was independently associated with improvements in function and leg symptom scores but was not associated with improvement in the back pain score. After surgery, patients with unilateral leg pain had significantly greater improvements in function and leg symptoms than patients with bilateral leg pain.

Conclusion. In patients undergoing surgery for degenerative lumbar spinal stenosis, the preoperative type of leg pain predicts function and leg symptom outcomes.

A total of 174 patients who underwent surgery for lumbar spinal stenosis were classified based on the type of leg pain. The preoperative leg pain type predicted 2-year outcomes. After surgery, patients with unilateral leg pain had greater improvement in function and leg symptoms than patients with bilateral leg pain.

From the *Department of Orthopedic Surgery, Nishinomiya Municipal Central Hospital, Nishinomiya, Japan; and the †Department of Orthopedic Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan.

Acknowledgment date: June 5, 2006. First revision date: April 20, 2006. Second revision date: September 17, 2006. Acceptance date: September 18, 2006.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprint requests to Kazuo Yamashita, MD, Department of Orthopedic Surgery, Nishinomiya Municipal Central Hospital, 8-24 Hayashida-cho, Nishinomiya 663-8014, Japan; E-mail: yamakazu@onh.go.jp

© 2007 Lippincott Williams & Wilkins, Inc.