Spinal decompression improves walking capacity in patients with lumbar spinal stenosis

Abstract

Introduction

Lumbar spinal stenosis (LSS) is a degenerative condition causing back and leg pain, limiting walking due to neurogenic claudication. It affects 9–11 % of the population, rising to 47 % in those over 60, with cases expected to increase as the population ages. Non-surgical treatments are considered first-line options, although their effectiveness remains uncertain. Decompression surgery is still commonly performed for severe cases, even though a review comparing conservative treatments with surgical procedures, including spinal decompression, found no clear superiority of surgery. In Denmark, LSS accounts for 35 % of spinal surgeries in adults.

Research question

Does spinal decompression improve walking distance and gait speed in patients suffering from LSS?

Methods

Consecutive patients scheduled for decompression due to spinal stenosis enrolled at a regional spine centre. Timed walking distance (maximum of 1000m) was performed at baseline and at 3-, and 12 months post-op.

Results

One hundred and one patients were included in the study, mean age was 70.7 years, 77 % were female, with 90 % having had symptoms for more than 6 months prior to surgery.

Walking distance (123.9m–791.1m, p < .001) and speed (0.91 m/s to 1.17 m/s, p < .001) improved at one year after surgery.

Discussion and conclusion

Patients with severe walking impairment caused by spinal stenosis experienced substantial improvement of both walking speed and walking distance at all follow-up time points after undergoing spinal decompression.