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Clinical Outcome of Nonoperative Treatment for Lumbar Spinal Stenosis, and Predictive Factors Relating to Prognosis, in a 5-Year Minimum Follow-up

Study Design A prospective long-term follow-up study of nonoperative treatment for lumbar spinal stenosis (LSS) and multivariable analysis of the prognosis. Objectives To clarify the outcomes of nonoperative treatment for LSS over a long-term follow-up, and to extrapolate factors relating to the prognosis of treatment. Summary of Background Data The indicators of treatment for LSS remain controversial, and few reports have evaluated the prognosis of its nonoperative treatment, or extrapolated the factors that aid prognosis. Methods One hundred twenty patients who received inpatient nonoperative treatment were followed up for 5 years or longer. Patients' nerve involvement and myelographic findings were classified, and the disturbance level of activities of daily living (ADL) at final follow-up was graded. The association between patients' age and sex, classification of nerve involvement and myelographic findings, recovery rate by initial nonoperative treatment, presence or absence of degenerative spondylolisthesis/scoliosis, and disturbance level of ADL were evaluated statistically to extrapolate prognostic factors. Results In all, 52.5% of patients showed no hindrance to ADL at follow-up. Patients who were classified as radicular type, or responded well to initial nonoperative treatment, exhibited statistically better results than did other patients. In contrast, accompanying degenerative scoliosis tended to be related to a poorer prognosis. Conclusion The current study demonstrated the long-term follow-up outcome of nonoperative treatment for LSS. Important factors relating to the prognosis were demonstrated. These factors could aid the decision-making process for treatment of LSS patients.