[Long-term results of the surgical treatment of lumbar stenosis].

Among 163 patients who underwent surgery for a degenerative lumbar stenosis, 79% were re-examined and evaluated retrospectively (2 to 14 years following surgery), using a functional grading scale. The grading scale (up to 20) assessed limping, radicular pain at rest and with effort, back pain, motor deficits, sphincter dysfunction, medication required, and quality of life. Satisfactory results were obtained in 83% with 87% reporting substantial functional improvement. Limping and radicular pain at rest responded most rapidly to surgical intervention. Subsequent disappearance of residual radicular pain occurred in 13% whether present at rest or with effort. Episodic radicular pain with effort persisted however, in approximately one-quarter of all patients, generally in those with more pronounced pain before surgery. One out of four patients had complete relief of back pain and most often without performing an arthrodesis. Major neurological deficits resolved extremely slowly but completely in six out of ten patients. On the grading scale of 20, four recovery profiles could be identified: a perfectly stable result (60%), regular improvement (14%), improvement with episodic aggravation of symptoms (19%) and subsequent worsening (8%). Overall, a second surgical intervention had to be performed in 5% of patients with complete bony excision or arthrodesis (for vertebral slippage or for back pain).