【Introduction】
Microdendoscopic laminectomy (MEL) is a widely performed procedure for lumbar spinal canal stenosis (LSCS). Although many patients are satisfied with MEL, a few patients are dissatisfied. Thus, it is important to assess the surgical outcomes and patient satisfaction. However, no studies have evaluated patient satisfaction after MEL. This study aimed to investigate patient satisfaction and predictors of poor satisfaction after MEL.
【Methods】
This is a retrospective cohort study that enrolled patients prospectively registered who underwent MEL for LSCS at our institution from April 2017 to May 2021. The patients were followed up with for a minimum of one-year after surgery. Based on their responses at the one-year follow-up, the patients were categorized into two groups. Satisfied patients (Group S) were those who responded that they were “satisfied”, and dissatisfied patients (Group D) were those who responded that they were “neither or dissatisfied”. We assessed clinical features, operative factors, the surgical outcomes, including the Numeric Rating Scale (NRS) for low back pain, arm pain, arm numbness, leg pain, leg numbness, foot pain, and foot numbness, Short Form-12 (SF-12), EuroQol 5 Dimension (EQ-5D), and Oswestry Disability Index (ODI). We statistically analyzed the differences between the two groups.
【Results】
A total of 300 consecutive patients underwent MEL. Among them, 252 (84%) were available for clinical outcome and satisfaction evaluation at one-year after surgery. The mean age at the time of surgery was 72.4 years with 151 male patients (60.0%). 215 patients (85.3%, Group S) were satisfied, and 37 patients (14.7%, Group D) were dissatisfied with MEL.
Preoperative oral steroid use was significantly more prevalent in Group D. No significant differences were observed in other preoperative clinical features and surgical data between the two groups. In terms of preoperative symptoms, NRS for arm numbness and foot numbness were significantly higher in Group D. All postoperative scores, except for the NRS for arm pain, indicated significantly worse outcomes in Group D.
【Discussion】
The majority of patients, 85.3%, were satisfied with MEL. However, 14.7% were dissatisfied. Preoperative oral steroid use, arm numbness, and foot numbness were found to be predictors of poor patient satisfaction after MEL. Patients with these predictors should be adequately informed of the potential for decreased satisfaction before undergoing MEL procedures.