Health outcome assessment before and after lumbar laminectomy for radiculopathy

Study Design. Forty-one patients undergoing lumbar laminectomy for radiculopathy resulting from herniated discs assessed their health status using a generic health outcome instrument (Medical Outcomes Study Short Form 36) before surgery and at an average of 2 years after surgery. Objectives. To assess whether lumbar laminectomy for herniated nucleus pulposus is a useful intervention when patients evaluate their own perception of health. Summary of Background Data. The Medical Outcomes Study Short Form 36 has been used in multiple studies assessing various medical conditions. It is brief, generic, and reliable. Although surgical treatment for radiculopathy by lumbar laminectomy hs been shown to be successful using specific criteria for patient selection and an algorithmic approach, the authors are not aware of any study using a patient-based health outcome assessment to evaluate the results of this type of surgery. Methods. Forty-one patients (82% completed follow-up evaluation; average follow-up period, 2.08 years) completed Medical Outcomes Study Short Form 36 before and after surgery. Scores from before and after surgery were compared. Results. Statistically significant improvements (P < 0.01) were seen in eight of the nine health scores comparing scores from before and after surgery at follow-up evaluation. These included physical function, social function, role function resulting from physical limitations, role function resulting from emotional limitations, mental health, vitality, pain, and perceived health change. No significant change was seen in the patients' health perception after surgery. Conclusions. This study shows that the patients' self-reported health outcomes after lumbar laminectomy correlate with the excellent results previously seen using physician-driven outcome measures in an appropriately selected population with radiculopathy. The excellent results shown here did not deteriorate with age (> 40 years compared with < 40 years) or with complications after surgery.