Abstract
Introduction: This study aimed to evaluate the effect of lumbar function by the number of decompression levels on postoperative lumbar function.
Methods: Between May 2017 and April 2019, 291 consecutive patients who were diagnosed with lumbar spinal canal stenosis and underwent microscopic posterior decompression surgery at our institution were included in this study. Patients (n = 170) who underwent single-level lumbar decompression were categorized into the S group, while patients (n = 121) who underwent multi-level lumbar decompression were categorized into the M group. The Japanese Orthopaedic Association score, Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), and visual analogue scale of low back pain were used to measure operative outcomes, and the scores of the groups were compared. The Mann-Whitney U-test was performed and Spearman's rank correlation coefficient was determined.
Results: The S group had significantly higher scores than the M group for postoperative lumbar spine dysfunction, walking ability, social life dysfunction, mental health on the JOABPEQ subscales, and amount of change in these scores. Significant correlations were observed between the number of decompression levels and walking ability on the JOABPEQ subscales.
Conclusions: We should readily perform multi-level lumbar decompression to prevent reoperation at other levels of the primary surgery. However, multilevel lumbar decompression surgery affects the lumbar function. Therefore, to prevent postoperative deterioration of lumbar spine function and low back pain, the age, affected levels, and spinal canal area, must be considered for each case, and appropriate decompression levels must be determined.
