Clinical classification of patients with lumbar spinal stenosis based on their leg pain syndrome: its correlation with 2-year surgical outcome.

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.