Evidence Tables

ECRI Health Technology Assessment Group

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

ECRI Health Technology Assessment Group. Treatment of Degenerative Lumbar Spinal Stenosis. Rockville (MD): Agency for Healthcare Research and Quality (US); 2001 Jun. (Evidence Reports/Technology Assessments, No. 32.)

This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

Evidence Tables

Evidence Table 1. Reporting of Patient Signs, Symptoms, and Other Characteristics Related to Lumbar Spinal Stenosis in Randomized Controlled Trials of Conservative Treatments

First Author and Year of Publication	Number of Patients in the Trial	Mean Age	Duration of Illness Prior to Treatment	Prior Surgery	Claudication	Back Pain	Leg Pain	Back and Leg Pain	Leg Weakness	Sensory Dysfunction	Relief of Pain by Flexion	Incontinence of Bowel or Bladder	Extent of Stenosis	Patients with Hip Disorder	Patients with Knee Disorder	Patients with Arthritis	Patients with Herniated Disks
Patients with Central or Lateral Lumbar Stenosis type of stenosis unspecified or includes both types of stenosis
Fukusaki, Kobayashi, Hara et al., 1998	53	Yes	Yes	No	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No
Eskola, Pohjolainen, Alaranta et al., 1992	39	Yes	Yes	Yes	No	No	No	Yes	No	No	No	No	Yes	No	No	No	No
Cuckler, Bernini, Wiesel et al., 1985	37	Yes	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Patients with Degenerative Spondylolisthesis
Sinaki, Lutness, Ilstrup et al., 1989	48	Yes	Yes	No	No	Yes	No	No	No	No	No	No	No	No	No	No	No
Number of Trials Reporting	4	4	4	1	1	1	1	1	0	0	0	0	1	0	0	0	0

Evidence Table 2. Reporting of Patient Signs, Symptoms, and Other Characteristics Related to Lumbar Spinal Stenosis in Trials of Surgical Treatments

Trials Examining Surgical Patients with CentralLumbar Stenosis
First Author and Year of Publication	Number of Patients in the Trial	Mean Age	Duration of Illness Prior to Treatment	Mean Number of Vertebral Levels Involved	Prior Surgery	Claudication	Back Pain	Leg Pain	Back and Leg Pain	Leg Weakness	Sensory Dysfunction	Relief of Pain by Flexion	Incontinence of Bowel or Bladder	Extent of Stenosis	Patients with Hip Disorder	Patients with Knee Disorder	Patients with Arthritis	Patients with Herniated Disks
Randomized Controlled Trials
Grob, Humke, and Dvorak, 1995	45	Yes	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No	No	No	Yes
Controlled Trials
Herno, Saari, Suomalainen et al., 1999	92	Yes	Yes	No	Yes	No	No	No	No	No	Yes	Yes	Yes	No	No	No	No	No
Herno, Partanen, Talaslahti et al., 1999	80	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Hanakita, Suwa, and MIzuno, 1999	164	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Thomas, Rea, Pikul et al., 1997	38	Yes	No	No	Yes	Yes	No	No	No	No	No	No	No	No	Yes	No	No	No
Yone, Sakou, Kawauchi et al., 1996	34	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Ray, 1982	65	Yes	Yes	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Surin, Hedelin, and Smith, 1982	22	Yes	No	No	No	Yes	No	No	No	No	Yes	No	No	Yes	No	No	No	No
Tajima, Fukazawa, and Ishio, 1980	27	Yes	No	Yes	No	Yes	Yes	Yes	No	Yes	Yes	No	No	No	No	No	No	No
Prospective Trials without Controls
Kleeman, Hiscoe, and Berg, 2000	54	Yes	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	No	No	No	No	Yes	No
Weiner, Walker, Brower et al., 1999	30	Yes	Yes	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No	No	No
diPierro, Helm, Shaffrey et al., 1996	35	Yes	No	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes	No	No	No	No	No	No	No
Retrospective Trial with Consecutive Patients
Vitaz, Raque, Shields et al., 1999	65	Yes	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	No	No	No	No	Yes
Matsui, Kanamori, Ishihara et al., 1997	27	Yes	No	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No	No	Yes
Airaksinen, Herno, Turunen et al., 1997	497	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	No	No	No	No	Yes	Yes	Yes	Yes	No
Mullin, Rea, Irsik et al., 1996	72	Yes	No	No	No	No	No	No	No	No	Yes	No	No	No	No	No	No	No
Ishac, Alhayek, Fournier et al., 1996	34	Yes	No	Yes	No	Yes	Yes	Yes	No	No	No	No	No	No	No	No	No	Yes
Jonsson and Stromqvist, 1994	43	Yes	Yes	Yes	Yes	No	No	No	No	No	No	No	No	No	Yes	Yes	No	No
Caputy and Luessenhop, 1992	100	Yes	Yes	No	Yes	Yes	No	No	No	No	No	No	No	No	Yes	Yes	No	Yes
Dhar and Porter, 1992	36	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Chahal, Mundkur, Sancheti et al., 1982	32	Yes	Yes	Yes	No	Yes	Yes	No	Yes	Yes	Yes	No	Yes	Yes	No	No	No	Yes
Rosomoff, 1981	50	No	No	Yes	Yes	No	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes	No	No	No	No
Getty, 1980	35	Yes	Yes	Yes	No	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	No	No	No	No	No
Reale, Deifini, Gambacona et al., 1978	37	Yes	No	No	No	No	No	No	No	Yes	Yes	No	Yes	No	No	No	No	Yes
Verbiest, 1977	116	No	No	No	No	Yes	Yes	Yes	No	No	No	No	No	No	No	No	No	Yes
Case-series
Young, Veerapen, and O'Laoire, 1988	32	No	No	No	Yes	Yes	Yes	Yes	No	Yes	Yes	No	No	No	No	No	No	No
Kurihara, Tanaka, Tsumura et al., 1988	12	Yes	No	No	No	Yes	No	Yes	No	Yes	Yes	No	No	No	No	No	No	No
Hall, Bartleson, Onofrio et al., 1985	68	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes	Yes	No	No	No	No	No	No
Weinstein, Scafuri, and McNeill, 1983	24	No	No	Yes	No	No	No	No	Yes	No	No	No	No	No	No	No	No	No
Weir and De Leo, 1981	81	Yes	No	No	No	Yes	No	No	No	No	No	No	No	Yes	No	No	No	No
Johnsson, Willner, and Pettersson, 1981	27	Yes	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No	No	Yes	No	No	No	No
Verbiest, 1979	11	Yes	No	Yes	No	Yes	Yes	Yes	No	Yes	Yes	No	No	Yes	No	No	No	No
Salibi, 1976	20	Yes	No	No	Yes	Yes	No	No	No	No	No	No	No	Yes	No	No	No	Yes
Number of Trials Reporting	33	27	11	19	13	21	14	14	7	12	15	2	6	8	4	3	2	9
Trials Examining Surgical Patients with Lateral Lumbar Stenosis
Randomized Controlled Trials
Lee and deBari, 1986	24	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Controlled Trials
Kirkaldy-Willis, Wedge, Yong-Hing et al., 1982	94	Yes	Yes	No	Yes	No	No	Yes	No	No	Yes	No	No	No	No	No	No	No
Mikhael, Ciric, Tarkington et al., 1981	85	Yes	Yes	No	No	Yes	No	Yes	No	Yes	Yes	Yes	Yes	No	No	No	No	Yes
Retrospective Trial with Consecutive Patients
Sanderson and Getty, 1996	66	Yes	Yes	Yes	No	Yes	Yes	Yes	No	Yes	Yes	No	No	No	No	No	No	Yes
Baba, Uchida, Maezawa et al., 1996	31	Yes	No	Yes	No	Yes	Yes	Yes	No	Yes	Yes	No	No	No	No	No	No	No
Aryanpur and Ducker, 1990	32	Yes	No	Yes	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No
Case-series
Choudhury and Taylor, 1977	28	No	No	No	No	No	Yes	Yes	No	Yes	Yes	No	Yes	No	No	No	No	Yes
Epstein, Epstein, Rosenthal et al., 1972	15	No	No	No	No	No	Yes	Yes	No	Yes	Yes	No	No	No	No	No	No	No
Number of Trials Reporting	8	6	3	3	2	2	4	6	0	5	6	1	2	0	0	0	0	2
Trials Examining Surgical Patients with Centralor Lateral Lumbar Stenosis type of stenosis unspecified or includes bothtypes of stenosis
Controlled Trials
Yone and Sakou, 1999	60	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Epstein, 1999	21	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Javid and Hadar, 1998	170	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes	No	No	No	No	No	No	No
Kalbarczyk, Lukes, and Seiler, 1998	148	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Pai and Kumar, 1996	55	Yes	No	No	No	Yes	Yes	Yes	No	Yes	Yes	No	Yes	No	No	No	No	No
Kawauchi, Yone, and Sakou, 1996	36	Yes	Yes	Yes	Yes	No	No	No	No	No	No	No	No	Yes	No	No	No	No
Cinotti, Postacchini, and Weinstein, 1994	50	Yes	Yes	No	No	Yes	No	No	No	Yes	No	Yes	No	No	No	No	No	No
Little and MacDonald, 1994	94	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Simpson, Silveri, Balderston et al., 1993	57	Yes	No	No	No	Yes	No	Yes	No	Yes	Yes	No	No	No	No	No	No	No
Jonsson and Stromqvist, 1993a	39	No	No	No	Yes	No	No	No	Yes	No	No	No	No	No	No	No	No	No
Nasca, 1989	114	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	Yes
Nather and Thomas, 1985	34	Yes	No	No	Yes	Yes	Yes	Yes	No	No	Yes	Yes	No	Yes	No	No	No	No
Paine, 1976	143	No	No	No	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No
Shenkin and Hash, 1976	49	Yes	No	No	Yes	No	Yes	Yes	Yes	No	No	No	No	Yes	No	No	No	No
Tile, McNeil, Zarins et al., 1976	26	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Retrospective Trials with Consecutive Patients
Crock, Shiraishi, and Crock, 1995	34	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes	No	Yes	No	No	No	No	No
Silvers, Lewis, and Asch, 1993	248	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	No	No	No	No	No	Yes
Katz, Lipson, Larson et al., 1991	88	Yes	Yes	Yes	Yes	Yes	Yes	No	No	Yes	Yes	Yes	No	No	No	No	Yes	No
Ganz, 1990	36	Yes	No	Yes	No	Yes	No	No	No	No	No	Yes	No	No	No	No	No	Yes
Case-series
Norcross-Nechay, Mathew, Simmons et al., 1999	70	Yes	No	No	No	Yes	Yes	Yes	No	No	No	No	No	No	No	No	No	No
Guigui, Benoist, Delecourt et al., 1998	50	Yes	No	Yes	No	No	No	Yes	No	Yes	No	No	No	Yes	No	No	No	Yes
Scholz, Firsching, and Lanksch, 1998	72	Yes	Yes	No	No	Yes	No	No	Yes	No	Yes	No	No	No	Yes	No	Yes	No
Tsai, Yang, and Bray, 1998	62	Yes	Yes	Yes	Yes	Yes	Yes	No	No	Yes	Yes	No	No	No	No	No	Yes	No
Mackay and Wheelwright, 1998	50	Yes	Yes	Yes	No	No	Yes	Yes	No	Yes	Yes	No	No	No	No	No	No	Yes
Whitecloud, Castro Jr, Brinker et al., 1998	35	Yes	No	Yes	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No	Yes
Spetzger, Bertalanffy, Reinges et al., 1997	29	Yes	Yes	Yes	No	Yes	Yes	No	No	No	Yes	No	Yes	No	No	No	No	Yes
Katz, Lipson, Chang et al., 1996	88	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No	No	No	Yes	No
Lehto and Honkanen, 1995	96	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes	No	No	No	No	No	No	No	No
Stucki, Liang, Fossel et al., 1995	230	Yes	No	No	No	No	No	Yes	Yes	Yes	Yes	No	No	No	No	No	No	No
Tuite, Stern, Doran et al., 1994	119	Yes	No	Yes	Yes	No	Yes	Yes	No	Yes	Yes	No	Yes	No	No	No	No	No
McCullen, Bernini, Bernstein et al., 1994	193	Yes	Yes	Yes	Yes	No	No	No	No	Yes	Yes	No	No	No	No	No	No	No
Simmons and Simmons, 1992	40	Yes	No	No	No	Yes	Yes	Yes	No	No	No	No	No	No	No	No	No	No
Mauersberger and Nietgen, 1989	92	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Johnsson, Redlund-Johnell, Uden et al., 1989	61	Yes	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Brodsky, Hendricks, Khalil et al., 1989	36	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Jalovaara, Lahde, Iikko et al., 1989	31	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	No	No	No	No	Yes	No	No	No	No
Fast, Robin, and Floman, 1985	19	Yes	No	No	No	Yes	Yes	Yes	No	No	No	Yes	No	No	No	No	No	No
Boccanera, Pellicioni, and Laus, 1984	25	Yes	No	No	Yes	Yes	No	No	Yes	Yes	Yes	No	No	No	No	No	No	No
Hood and Weigl, 1983	21	No	No	Yes	No	Yes	Yes	Yes	No	Yes	No	No	No	No	No	No	No	No
Scafuri and Weinstein, 1981	27	Yes	Yes	Yes	No	Yes	Yes	Yes	No	Yes	Yes	No	Yes	No	No	No	No	No
Echeverria and Lockwood, 1979	35	Yes	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No
Scapinelli, 1978	23	No	No	No	No	Yes	Yes	Yes	No	No	Yes	No	Yes	No	No	No	No	No
Vestad and Naca, 1977	80	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No
McKinley and Davis, 1976	32	Yes	Yes	Yes	No	Yes	Yes	Yes	No	Yes	Yes	No	Yes	No	No	No	No	No
Teng and Papatheodorou, 1963	29	No	No	Yes	No	No	Yes	Yes	No	Yes	Yes	No	No	No	No	No	No	No
Epstein, Epstein, and Lavine, 1962	29	No	No	No	No	No	No	No	No	No	No	No	Yes	No	No	No	No	No
Epstein, 1960	14	No	No	No	No	No	Yes	No	No	Yes	Yes	No	Yes	No	No	No	No	No
Number of Trials Reporting	47	36	17	22	17	22	23	20	7	20	20	5	9	5	1	0	4	7
Trials Examining Surgical Patients with Degenerative Spondylolisthesis
Randomized Controlled Trials
Fischgrund, Mackay, Herkowitz et al., 1997	75	Yes	No	Yes	Yes	Yes	Yes	Yes	No	No	No	No	No	No	No	No	No	No
Thomsen, Christensen, Eiskjaer et al., 1997	41	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Bridwell, Sedgewick, O'Brien et al., 1993	43	Yes	No	Yes	Yes	Yes	No	No	No	No	No	No	No	No	No	No	No	No
Herkowitz and Kurz, 1991	50	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Controlled Trials
Plotz and Benini, 1998	106	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Yuan, Garfin, Dickman et al., 1994	2684	Yes	No	Yes	Yes	No	Yes	Yes	No	No	No	No	No	No	No	No	No	No
Satomi, Hirabayashi, Toyama et al., 1992	41	Yes	Yes	No	No	Yes	Yes	Yes	No	No	No	No	Yes	Yes	No	No	No	No
Lombardi, Wiltse, Reynolds et al., 1985	47	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Prospective Trials
Nakai, Yoshizawa, and Kobayashi, 1999	23	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Rechtine, Sutterlin, Wood et al., 1996	18	Yes	No	Yes	Yes	No	No	No	No	No	No	No	No	Yes	No	No	No	No
Retrospective Trials with Consecutive Patients
Stambough, 1999	35	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Nishizawa and Fujimura, 1997	58	Yes	No	Yes	No	No	No	No	No	No	No	No	No	Yes	No	No	No	No
Moller, Wittenberg, Nolte et al., 1992	37	Yes	No	Yes	No	No	No	No	No	No	No	No	No	Yes	No	No	No	No
Marchesi, Thalgott, and Aebi, 1991	30	Yes	No	No	No	Yes	No	No	No	No	No	No	No	Yes	No	No	No	No
Takahashi, Kitahara, Yamagata et al., 1990	39	Yes	No	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No	No	No
Knox, Harvell, Nelson et al., 1989	39	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	No	No	No	No	No	No	Yes	No
Case-series
Booth, Bridwell, Eisenberg et al., 1999	49	Yes	No	Yes	Yes	Yes	No	No	No	No	No	No	No	No	No	No	No	No
McCulloch, 1998	21	Yes	No	Yes	No	No	No	Yes	No	No	No	No	No	No	No	No	No	No
Epstein, 1998b	28	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	Yes
Mochida, Toh, Suzuki et al., 1997	10	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Epstein, 1998a	290	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	Yes
Grob, Humke, and Dvorak, 1996	18	Yes	No	Yes	No	Yes	Yes	No	No	No	No	No	No	No	No	No	No	No
Herron and Trippi, 1989	24	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No	No	No	No	No
Chang and McAfee, 1989	17	Yes	No	No	No	No	Yes	No	No	No	No	No	No	No	No	No	No	No
Inoue, Watanabe, Goto et al., 1988	36	Yes	No	No	No	Yes	Yes	Yes	No	No	Yes	No	No	No	No	No	No	Yes
Simmons and Capicotto, 1988	15	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Hanley, 1986	20	Yes	No	Yes	Yes	No	Yes	Yes	No	No	No	No	No	No	No	No	No	No
Kaneda and Kazama, 1986	54	Yes	No	Yes	No	Yes	Yes	Yes	No	Yes	Yes	No	No	No	No	No	No	Yes
Alexander Jr, Kelly Jr, Davis Jr et al., 1985	50	Yes	No	Yes	Yes	No	No	Yes	No	No	No	No	No	No	No	No	No	Yes
Dall and Rowe, 1985	26	Yes	No	Yes	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No	No
Epstein, Epstein, Carras et al., 1983	60	Yes	Yes	No	Yes	Yes	No	No	Yes	Yes	Yes	No	No	No	Yes	Yes	Yes	Yes
Richardson and Brown, 1980	21	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Cauchoix, Benoist, and Chassaing, 1976	26	No	No	Yes	No	Yes	Yes	Yes	No	Yes	Yes	No	Yes	No	No	No	No	No
Epstein, Epstein, Lavine et al., 1976	20	No	No	No	No	Yes	Yes	No	No	No	Yes	Yes	Yes	No	No	No	No	No
Number of Trials Reporting	34	31	4	21	11	14	12	11	2	5	5	1	3	5	1	1	2	6
Trials Examining Surgical Patients with LumbarStenosis and/or Degenerative Spondylolisthesis
Controlled Trials
Rompe, Eysel, Zollner et al., 1999	117	Yes	Yes	Yes	Yes	No	No	No	Yes	Yes	Yes	No	No	No	No	No	No	No
Katz, Lipson, Lew et al., 1997	272	Yes	Yes	Yes	Yes	No	No	No	No	Yes	Yes	No	No	No	No	No	No	No
Sato and Kikuchi, 1997	81	Yes	Yes	Yes	No	Yes	No	No	No	No	No	No	No	Yes	No	No	No	No
Rompe, Eysel, Hopf et al., 1995	60	Yes	Yes	Yes	Yes	Yes	Yes	No	No	Yes	Yes	No	No	No	No	No	No	Yes
Sanderson and Wood, 1993	34	Yes	Yes	Yes	No	Yes	No	Yes	No	No	No	No	No	Yes	No	No	No	No
Robertson, Grobler, Novotny et al., 1993	33	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Postacchini, Cinotti, Perugia et al., 1993	70	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Hirabayashi, Kumano, and Kuroki, 1991	53	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Herkowitz and Garfin, 1989	99	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Prospective Trials
Jonsson, Annertz, Sjoberg et al., 1997a	105	Yes	Yes	Yes	No	Yes	Yes	Yes	No	No	No	No	No	Yes	Yes	Yes	No	No
Postacchini and Conotti, 1992	88	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Retrospective Trials with Consecutive Patients
Chen, Baba, Kamitani et al., 1994	80	Yes	No	Yes	No	No	No	No	No	No	No	No	No	Yes	No	No	No	No
Postacchini, Cinotti, Gumina et al., 1993	64	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Case-series
Guigui, Barre, Benoist et al., 1999	28	Yes	No	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Number of Trials Reporting	14	12	6	11	3	4	2	2	1	3	3	0	0	4	1	1	0	1
Trials Examining Surgical Patients and Patients Receiving Conservative Treatment
Patients with Central Lumbar Stenosis
Simotas, Dorey, Hansraj et al., 2000	55	Yes	No	Yes	Yes	No	No	No	No	No	No	No	No	Yes	No	No	No	No
Mariconda, Zanforlino, Celestino et al., 2000	37	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes	No	No	No	No	No	No	No
Johnsson, Uden, and Rosen, 1991	76	Yes	Yes	Yes	Yes	Yes	No	Yes	No	No	No	No	No	Yes	No	No	No	No
Patients with Central or Lateral Lumbar Stenosis Unspecified
Amundsen T, Weber H, Nordal HJ et al., 2000	100	No	No	No	Yes	No	No	Yes	No	No	No	No	No	Yes	No	No	No	No
Hurri, Slatis, Soini et al., 1998	134	Yes	No	No	Yes	No	Yes	Yes	No	No	Yes	No	No	Yes	No	No	No	No
Atlas, Deyo, Keller et al., 1996	148	Yes	No	No	Yes	Yes	Yes	Yes	No	Yes	Yes	No	No	No	No	No	No	No
Swezey, 1996	47	Yes	Yes	No	No	Yes	No	No	No	No	No	No	No	No	No	No	No	No
Nagler and Bodack, 1993	100	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Herno, Airaksinen, Saari et al., 1996	57	Yes	Yes	No	No	Yes	No	Yes	No	No	No	No	No	Yes	No	No	No	No
Patients with Degenerative Spondylolisthesis
Fitzgerald and Newman, 1976	43	Yes	No	No	No	No	Yes	No	No	No	No	No	No	No	No	No	No	No
Rosenberg, 1976	200	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	Yes
Number of Trials Reporting	11	10	4	3	5	5	4	6	0	2	3	0	0	5	0	0	0	1
Summary of All Surgical Trials Reporting Signs, Symptoms, and Patient CharacteristicsRelated to Treatment of Lumbar Spinal Stenosis
Total Number Reporting	147	122	45	79	52	68	59	59	17	47	52	9	20	27	7	5	8	26
Percentage of Trials Reporting	100%	83%	31%	54%	35%	46%	40%	40%	12%	32%	35%	6%	14%	18%	5%	3%	5%	18%

Evidence Table 3. Reporting of Patient Signs, Symptoms, and Other Characteristics Related to Lumbar Spinal Stenosis in Trials Describing Only the Natural History of Lumbar Spinal Stenosis Patients

First Author and Year of Publication	Number of Patients in the Trial	Mean Age	Duration of Illness Prior to Treatment	Mean Number of Vertebral Levels Involved	Prior Surgery	Claudication	Back Pain	Leg Pain	Back and Leg Pain	Leg Weakness	Sensory Dysfunction	Relief of Pain by Flexion	Incontinence of Bowel or Bladder	Extent of Stenosis	Patients with Hip Disorder	Patients with Knee Disorder	Patients with Arthritis	Patients with Herniated Disks
Patients with Central Lumbar Stenosis
Hamdan and Al-Kaissie, 1994	75	Yes	Yes	No	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	No	No	No
Patients with Lateral Lumbar Stenosis
Jonsson and Stromqvist, 1993b	100	Yes	Yes	No	No	Yes	Yes	No	No	No	Yes	Yes	No	No	No	No	No	No
Patients with Degenerative Spondylolisthesis
Matsunaga, Sakou, Morizono et al., 1990	40	Yes	No	No	No	Yes	Yes	Yes	No	Yes	Yes	No	Yes	No	No	No	No	No
Sato, Wakamatsu, Yoshizumi et al., 1989	355	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Patients with Lumbar Stenosis and Spondylolisthesis
Radu and Menkes, 1998	62	Yes	No	No	No	Yes	Yes	Yes	No	Yes	Yes	No	No	No	No	No	No	Yes
Amundsen, Weber, Lilleas et al., 1995	100	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	No	No	Yes
Johnsson, Uden, and Rosen, 1992	32	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	No	No	No	No	Yes	No	No	No	No
Number of Trials Reporting	7	6	4	2	2	6	6	5	2	4	5	3	3	3	0	0	0	1

Evidence Table 4. Reporting of Outcomes in Randomized Controlled Trials of Conservative Treatment


First Author and Year of Publication	Number of Patients in the Trial	Measured Back Pain	Measured Back Pain Relief	Measured Leg Pain	Measured Leg Pain Relief	Measured Walking Capacity	Measured Global Success of Treatment	Measured Ability to Work	Measured Quality of Life	Measured Mental Status	Measured Disability or Dependency	Measured Activities of Daily Living
Patients with Central or Lateral Lumbar Stenosis type of stenosis unspecified or includes both types of stenosis
Fukusaki, Kobayashi, Hara et al., 1998	53	No	No	No	No	Yes	No	No	No	No	No	No
Eskola, Pohjolainen, Alaranta et al., 1992	39	Yes	No	No	No	Yes	No	No	No	No	No	No
Cuckler, Bernini, Wiesel et al., 1985	37	No	No	No	No	No	Yes	No	No	No	No	No
Patients with Degenerative Spondylolisthesis
Sinaki, Lutness, Ilstrup et al., 1989	48	Yes	No	No	No	No	Yes	Yes	No	No	No	No
Number of Trials Reporting	4	2	0	0	0	2	2	1	0	0	0	0

Evidence Table 5. Reporting of Outcomes Related to Treatment of Lumbar Spinal Stenosis in Trials of Surgical Treatment

Trials Examining Surgical Patients with Central Lumbar Stenosis
First Author and Year of Publication	Number of Patients in the Trial	Measured Back Pain	Measured Back Pain Relief	Measured Leg Pain	Measured Leg Pain Relief	Measured Walking Capacity	Measured Global Success of Treatment	Measured Ability to Work	Measured Quality of Life	Measured Mental Status	Measured Disability or Dependency	Measured Activities of Daily Living
Randomized Controlled Trials
Grob, Humke, and Dvorak, 1995	45	Yes	Yes	No	Yes	Yes	Yes	No	No	No	No	No
Controlled Trials
Herno, Saari, Suomalainen et al., 1999	92	Yes	No	Yes	No	Yes	Yes	No	No	No	Yes	No
Herno, Partanen, Talaslahti et al., 1999	80	No	No	No	No	Yes	Yes	No	No	No	Yes	No
Hanakita, Suwa, and MIzuno, 1999	164	Yes	No	Yes	No	Yes	Yes	No	No	No	No	No
Thomas, Rea, Pikul et al., 1997	38	No	No	No	No	Yes	No	No	No	No	No	No
Yone, Sakou, Kawauchi et al., 1996	34	Yes	No	Yes	No	Yes	Yes	No	No	No	No	No
Ray, 1982	65	No	No	No	No	No	Yes	No	No	No	No	No
Surin, Hedelin, and Smith, 1982	22	No	No	No	No	No	No	No	No	No	No	No
Tajima, Fukazawa, and Ishio, 1980	27	No	No	No	No	No	Yes	No	No	No	No	No
Prospective Trials without Controls
Kleeman, Hiscoe, and Berg, 2000	54	No	Yes	No	Yes	Yes	Yes	No	No	No	No	No
Weiner, Walker, Brower et al., 1999	30	No	No	No	No	Yes	Yes	No	No	No	No	No
diPierro, Helm, Shaffrey et al., 1996	35	Yes	No	No	No	No	Yes	No	No	No	No	No
Retrospective Trial with Consecutive Patients
Vitaz, Raque, Shields et al., 1999	65	Yes	No	Yes	No	Yes	No	No	No	No	No	No
Matsui, Kanamori, Ishihara et al., 1997	27	Yes	No	No	No	No	Yes	No	No	No	No	No
Airaksinen, Herno, Turunen et al., 1997	497	No	No	No	No	Yes	No	Yes	No	No	Yes	No
Mullin, Rea, Irsik et al., 1996	72	No	No	No	No	Yes	Yes	No	No	No	No	No
Ishac, Alhayek, Fournier et al., 1996	34	No	Yes	No	Yes	Yes	Yes	No	No	No	No	No
Jonsson and Stromqvist, 1994	43	No	No	Yes	No	Yes	No	No	No	No	No	No
Caputy and Luessenhop, 1992	100	No	No	No	No	No	Yes	No	No	No	No	No
Dhar and Porter, 1992	36	No	No	No	No	No	Yes	No	No	No	No	No
Chahal, Mundkur, Sancheti et al., 1982	32	No	No	No	No	No	Yes	No	No	No	No	No
Rosomoff, 1981	50	No	No	No	No	No	Yes	No	No	No	No	No
Getty, 1980	35	No	No	No	No	No	Yes	No	No	No	No	No
Reale, Deifini, Gambacona et al., 1978	37	No	No	No	No	No	Yes	No	No	No	No	No
Verbiest, 1977	116	No	No	No	No	No	Yes	No	No	No	No	No
Case-series
Young, Veerapen, and O'Laoire, 1988	32	No	No	No	Yes	No	Yes	No	No	No	No	No
Kurihara, Tanaka, Tsumura et al., 1988	12	No	No	No	No	No	Yes	No	No	No	No	No
Hall, Bartleson, Onofrio et al., 1985	68	No	No	No	No	Yes	Yes	No	No	No	Yes	No
Weinstein, Scafuri, and McNeill, 1983	24	No	No	No	No	No	Yes	No	No	No	No	No
Weir and De Leo, 1981	81	No	No	No	No	No	Yes	No	No	No	No	No
Johnsson, Willner, and Pettersson, 1981	27	Yes	No	Yes	No	Yes	Yes	No	No	No	No	No
Verbiest, 1979	11	No	Yes	No	Yes	Yes	No	No	No	No	No	No
Salibi, 1976	20	No	No	No	No	No	Yes	No	No	No	No	No
Number of Trials Reporting	33	8	4	6	5	16	27	1	0	0	2	0
Randomized Controlled Trials
Lee and deBari, 1986	24	No	No	No	No	No	Yes	No	No	No	No	No
Controlled Trials
Kirkaldy-Willis, Wedge, Yong-Hing et al., 1982	94	No	No	Yes	No	No	Yes	Yes	No	No	No	No
Mikhael, Ciric, Tarkington et al., 1981	85	No	No	No	No	No	Yes	No	No	No	No	No
Retrospective Trial with Consecutive Patients
Sanderson and Getty, 1996	66	No	No	Yes	No	Yes	Yes	Yes	No	No	No	No
Baba, Uchida, Maezawa et al., 1996	31	No	Yes	No	Yes	Yes	Yes	No	No	No	No	No
Aryanpur and Ducker, 1990	32	No	No	No	No	No	Yes	No	No	No	No	No
Case-series
Choudhury and Taylor, 1977	28	Yes	No	Yes	No	No	Yes	Yes	No	No	No	No
Epstein, Epstein, Rosenthal et al., 1972	15	No	No	No	No	No	Yes	No	No	No	No	No
Number of Trials Reporting	8	1	1	3	1	2	8	3	0	0	0	0
Trials Examining Surgical Patients with Central or Lateral Lumbar Stenosis type of stenosis unspecified or includes both types of stenosis
Controlled Trials
Yone and Sakou, 1999	60	Yes	Yes	Yes	Yes	Yes	Yes	No	No	No	No	No
Epstein, 1999	21	No	No	No	No	No	Yes	No	No	No	No	No
Javid and Hadar, 1998	170	Yes	No	Yes	No	Yes	Yes	Yes	No	No	No	No
Kalbarczyk, Lukes, and Seiler, 1998	148	No	No	No	No	No	Yes	No	No	No	No	No
Pai and Kumar, 1996	55	No	No	No	No	No	Yes	No	No	No	No	No
Kawauchi, Yone, and Sakou, 1996	36	Yes	No	No	No	No	Yes	No	No	No	No	No
Cinotti, Postacchini, and Weinstein, 1994	50	No	No	No	No	No	Yes	No	No	No	No	No
Little and MacDonald, 1994	94	No	No	No	No	No	No	No	No	No	Yes	No
Simpson, Silveri, Balderston et al., 1993	57	No	No	No	No	No	Yes	No	No	No	No	Yes
Jonsson and Stromqvist, 1993a	39	No	No	No	Yes	No	No	No	No	No	No	No
Nasca, 1989	114	No	No	No	No	No	Yes	No	No	No	No	No
Nather and Thomas, 1985	34	No	No	No	No	No	Yes	No	No	No	No	No
Paine, 1976	143	No	No	No	No	No	Yes	No	No	No	No	No
Shenkin and Hash, 1976	49	No	No	No	No	No	Yes	No	No	No	No	No
Tile, McNeil, Zarins et al., 1976	26	No	No	No	No	No	Yes	No	No	No	No	No
Retrospective Trials with Consecutive Patients
Crock, Shiraishi, and Crock, 1995	34	No	No	No	No	No	Yes	No	No	No	No	No
Silvers, Lewis, and Asch, 1993	248	No	Yes	No	No	No	Yes	No	No	No	No	Yes
Katz, Lipson, Larson et al., 1991	88	Yes	No	No	No	Yes	Yes	No	No	No	No	No
Ganz, 1990	36	No	Yes	No	Yes	No	Yes	No	No	No	No	No
Case-series
Norcross-Nechay, Mathew, Simmons et al., 1999	70	No	Yes	No	No	No	No	No	No	No	No	No
Guigui, Benoist, Delecourt et al., 1998	50	No	No	No	No	No	Yes	No	No	No	No	No
Scholz, Firsching, and Lanksch, 1998	72	No	Yes	No	No	No	Yes	No	No	No	No	No
Tsai, Yang, and Bray, 1998	62	Yes	No	Yes	No	No	Yes	No	No	No	No	No
Mackay and Wheelwright, 1998	50	Yes	No	Yes	No	Yes	Yes	No	No	No	No	No
Whitecloud, Castro Jr, Brinker et al., 1998	35	Yes	No	No	No	No	No	Yes	No	No	No	No
Spetzger, Bertalanffy, Reinges et al., 1997	29	No	Yes	No	No	No	Yes	No	No	No	No	No
Katz, Lipson, Chang et al., 1996	88	Yes	No	Yes	No	Yes	Yes	No	No	No	No	No
Lehto and Honkanen, 1995	96	No	No	No	No	No	Yes	No	No	No	No	No
Stucki, Liang, Fossel et al., 1995	230	No	No	No	No	No	Yes	No	No	No	No	No
Tuite, Stern, Doran et al., 1994	119	No	No	No	No	No	Yes	No	No	No	No	No
McCullen, Bernini, Bernstein et al., 1994	193	Yes	Yes	No	No	No	Yes	No	No	No	No	Yes
Simmons and Simmons, 1992	40	Yes	No	Yes	No	No	No	No	No	No	No	No
Mauersberger and Nietgen, 1989	92	No	No	No	No	No	Yes	No	No	No	No	No
Johnsson, Redlund-Johnell, Uden et al., 1989	61	No	No	No	No	No	Yes	No	No	No	No	No
Brodsky, Hendricks, Khalil et al., 1989	36	No	No	No	No	No	Yes	No	No	No	No	No
Jalovaara, Lahde, Iikko et al., 1989	31	No	No	No	No	No	Yes	No	No	No	No	No
Fast, Robin, and Floman, 1985	19	No	Yes	No	No	Yes	No	No	No	No	No	No
Boccanera, Pellicioni, and Laus, 1984	25	No	No	No	No	No	Yes	No	No	No	No	No
Hood and Weigl, 1983	21	No	Yes	No	No	Yes	Yes	No	No	No	No	No
Scafuri and Weinstein, 1981	27	No	No	No	No	No	Yes	No	No	No	No	No
Echeverria and Lockwood, 1979	35	No	No	No	No	No	Yes	No	No	No	No	No
Scapinelli, 1978	23	No	No	No	No	No	Yes	No	No	No	No	No
Vestad and Naca, 1977	80	No	Yes	No	No	No	Yes	Yes	No	No	No	No
McKinley and Davis, 1976	32	No	No	No	No	No	Yes	No	No	No	No	No
Teng and Papatheodorou, 1963	29	No	No	No	No	No	Yes	No	No	No	No	No
Epstein, Epstein, and Lavine, 1962	29	No	No	No	No	No	Yes	No	No	No	No	No
Epstein, 1960	14	No	No	No	No	No	Yes	No	No	No	No	No
Number of Trials Reporting	47	10	10	6	3	7	41	3	0	0	1	3
Trials Examining Surgical Patients with Degenerative Spondylolisthesis
Randomized controlled Trials
Fischgrund, Mackay, Herkowitz et al., 1997	75	Yes	No	Yes	No	No	Yes	No	No	No	No	No
Thomsen, Christensen, Eiskjaer et al., 1997	41	No	No	No	No	No	No	No	Yes	Yes	No	Yes
Bridwell, Sedgewick, O'Brien et al., 1993	43	No	No	No	No	Yes	No	No	No	No	No	No
Herkowitz and Kurz, 1991	50	Yes	No	Yes	No	No	Yes	No	No	No	No	No
Controlled Trials
Plotz and Benini, 1998	106	No	Yes	No	Yes	No	Yes	No	No	No	No	No
Yuan, Garfin, Dickman et al., 1994	2684	No	Yes	No	Yes	No	No	No	No	No	No	Yes
Satomi, Hirabayashi, Toyama et al., 1992	41	Yes	No	Yes	No	Yes	Yes	No	No	No	No	No
Lombardi, Wiltse, Reynolds et al., 1985	47	No	No	No	No	No	Yes	No	No	No	No	No
Prospective Trials
Nakai, Yoshizawa, and Kobayashi, 1999	23	No	No	No	No	No	Yes	No	No	No	No	No
Rechtine, Sutterlin, Wood et al., 1996	18	No	Yes	No	No	No	No	Yes	No	No	No	Yes
Retrospective Trials with Consecutive Patients
Stambough, 1999	35	Yes	No	Yes	No	No	No	No	No	No	No	No
Nishizawa and Fujimura, 1997	58	Yes	No	Yes	No	Yes	Yes	No	No	No	No	No
Moller, Wittenberg, Nolte et al., 1992	37	No	No	No	No	No	Yes	No	No	No	No	No
Marchesi, Thalgott, and Aebi, 1991	30	No	No	No	No	No	Yes	No	No	No	No	No
Takahashi, Kitahara, Yamagata et al., 1990	39	No	No	No	No	Yes	Yes	No	No	No	No	Yes
Knox, Harvell, Nelson et al., 1989	39	Yes	No	Yes	No	Yes	Yes	Yes	No	No	No	No
Case-series
Booth, Bridwell, Eisenberg et al., 1999	49	Yes	No	No	No	No	Yes	Yes	No	Yes	Yes	Yes
McCulloch, 1998	21	No	No	No	No	No	Yes	No	No	No	No	No
Epstein, 1998b	28	No	No	No	No	No	Yes	No	No	No	No	No
Mochida, Toh, Suzuki et al., 1997	10	No	No	No	No	No	Yes	No	No	No	No	No
Epstein, 1998a	290	No	No	No	No	No	Yes	No	No	No	No	No
Grob, Humke, and Dvorak, 1996	18	Yes	No	No	No	Yes	No	Yes	No	No	No	No
Herron and Trippi, 1989	24	No	Yes	No	Yes	No	Yes	No	No	No	No	No
Chang and McAfee, 1989	17	No	No	No	No	No	Yes	No	No	No	No	No
Inoue, Watanabe, Goto et al., 1988	36	Yes	No	Yes	No	Yes	No	No	No	No	No	Yes
Simmons and Capicotto, 1988	15	No	No	No	No	No	No	No	No	No	No	No
Hanley, 1986	20	No	No	No	No	No	Yes	No	No	No	No	No
Kaneda and Kazama, 1986	54	No	No	No	No	No	Yes	No	No	No	No	No
Alexander Jr, Kelly Jr, Davis Jr et al., 1985	50	No	Yes	No	No	No	No	No	No	No	No	No
Dall and Rowe, 1985	26	Yes	No	No	No	No	Yes	No	No	No	No	No
Epstein, Epstein, Carras et al., 1983	60	No	No	No	No	No	Yes	No	No	No	No	No
Richardson and Brown, 1980	21	No	No	No	No	No	Yes	No	No	No	No	No
Cauchoix, Benoist, and Chassaing, 1976	26	No	No	No	No	No	Yes	No	No	No	No	No
Epstein, Epstein, Lavine et al., 1976	20	No	No	No	No	No	No	No	No	No	No	No
Number of Trials Reporting	34	1	4	7	3	7	24	4	1	2	1	6
Trials Examining Surgical Patients with Lumbar Stenosis and/or Degenerative Spondylolisthesis
Controlled Trials
Rompe, Eysel, Zollner et al., 1999	117	Yes	Yes	No	No	Yes	Yes	No	No	No	No	Yes
Katz, Lipson, Lew et al., 1997	272	Yes	No	Yes	No	Yes	Yes	No	No	No	No	No
Sato and Kikuchi, 1997	81	Yes	Yes	Yes	No	No	No	No	No	No	No	No
Rompe, Eysel, Hopf et al., 1995	60	Yes	No	No	No	No	Yes	No	No	No	No	No
Sanderson and Wood, 1993	34	No	No	No	No	No	Yes	No	No	No	No	No
Robertson, Grobler, Novotny et al., 1993	33	No	No	No	No	No	No	No	No	No	No	No
Postacchini, Cinotti, Perugia et al., 1993	70	No	Yes	No	Yes	No	Yes	No	No	No	No	No
Hirabayashi, Kumano, and Kuroki, 1991	53	No	No	No	No	No	Yes	No	No	No	No	No
Herkowitz and Garfin, 1989	99	No	No	No	No	No	Yes	No	No	No	No	No
Prospective Trials
Jonsson, Annertz, Sjoberg et al., 1997a	105	Yes	No	No	No	Yes	Yes	No	No	No	No	No
Postacchini and Conotti, 1992	88	No	No	No	No	No	Yes	No	No	No	No	No
Retrospective Trials with Consecutive Patients
Chen, Baba, Kamitani et al., 1994	80	No	No	No	No	No	No	No	No	No	No	Yes
Postacchini, Cinotti, Gumina et al., 1993	64	No	No	No	No	No	Yes	No	No	No	No	No
Case-series
Guigui, Barre, Benoist et al., 1999	28	No	No	No	No	No	Yes	No	No	No	No	No
Number of Trials Reporting	14	5	3	2	1	3	11	0	0	0	0	2
Trials Examining Surgical Patients and Patients Receiving Conservative Treatment
Patients with Central Lumbar Stenosis
Simotas, Dorey, Hansraj et al., 2000	55	Yes	No	Yes	No	Yes	Yes	No	No	No	No	No
Mariconda, Zanforlino, Celestino et al., 2000	37	Yes	No	Yes	No	Yes	Yes	No	Yes	No	No	No
Johnsson, Uden, and Rosen, 1991	76	Yes	No	No	No	Yes	Yes	Yes	No	No	No	No
Patients with Central or Lateral Lumbar Stenosis Unspecified
Amundse, Weber, Nordal et al., 2000	100	No	No	Yes	No	No	Yes	No	No	No	No	No
Hurri, Slatis, Soini et al., 1998	134	No	No	No	No	No	Yes	No	No	No	Yes	No
Atlas, Deyo, Keller et al., 1996	148	No	Yes	No	Yes	No	Yes	No	Yes	No	Yes	Yes
Swezey, 1996	47	No	No	No	No	No	Yes	No	No	No	No	No
Nagler and Bodack, 1993	100	No	No	No	No	No	Yes	No	No	No	No	No
Herno, Airaksinen, Saari et al., 1996	57	No	No	No	No	No	No	No	No	No	Yes	Yes
Patients with Degenerative Spondylolisthesis
Fitzgerald and Newman, 1976	43	No	No	No	No	No	Yes	No	No	No	No	No
Rosenberg, 1976	200	No	No	No	No	No	Yes	No	No	No	No	No
Number of Trials Reporting	11	3	1	3	1	3	10	1	2	0	3	2
Summary of All Surgical Trials Reporting Outcomes Related to Treatment of Lumbar Spinal Stenosis
Total Number Reporting	147	37	23	27	14	38	122	12	3	2	7	13
Percentage of Trials Reporting	100%	25%	16%	18%	10%	26%	83%	8%	2%	1%	5%	9%

Evidence Table 6. General Study Design Information for Clinical Trials of Patients with Lumbar Spinal Stenosis

Randomized Controlled Trials of Patients Receiving Conservative Treatments
First Author and Year of Publication	Number of Patients in the Trial	Years When Trial was Conducted	Number of Trial Centers	Institution of First Author	Country Where Trial was Conducted	Funding Source for Trial
Patients with Central or Lateral Lumbar Stenosis type of stenosis unspecified or includes both types of stenosis
Fukusaki, Kobayashi, Hara et al., 1998	53		Single	Nagasaki Rosai Hospital	Japan	Not Stated
Eskola, Pohjolainen, Alaranta et al., 1992	39		Single	The Orthopaedic Hospital of the Invalid Foundation, Helsinki, Finland	Finland	Not Stated
Cuckler, Bernini, Wiesel et al., 1985	37			Pennsylvania Hospital	United States
Patients with Degenerative Spondylolisthesis
Sinaki, Lutness, Ilstrup et al., 1989	48		Single	Mayo Clinic	United States
Trials Examining Surgical Patients with Central Lumbar Stenosis
Randomized controlled Trial
Grob, Humke, and Dvorak, 1995	45	1989-1990	Single	Schulthess Hospital	Switzerland	No funds were received in support of this study.
Controlled Trials
Herno, Saari, Suomalainen et al., 1999	92	1985-1988	Single	Kuopio University Hospital	Finland	Not reported
Herno, Partanen, Talaslahti et al., 1999	80	1982-1984	Single	Kuopio University Hospital	Finland	Not reported
Hanakita, Suwa, and MIzuno, 1999	164	1990-1998	Single	Shizuoka Gneral Hospital	Japan	Not reported
Thomas, Rea, Pikul et al., 1997	38	1990-1992	Single	Ohio State University	United States	not reported
Yone, Sakou, Kawauchi et al., 1996	34	1988-1992	Single	Kagoshima University	Japan	Not reported
Ray, 1982	65	1978-1980	Single	Institute for Low Back Care, Sister Kenny Institute, Minnesota	United States	Not reported
Surin, Hedelin, and Smith, 1982	22	1974-1980	Single	Central Hospital, Boras, Sweden	Sweden
Tajima, Fukazawa, and Ishio, 1980	27	1977-1980	Single	Miyazaki Medical College	Japan	Not reported
Prospective Trials
Kleeman, Hiscoe, and Berg, 2000	54	1992-1995	Single	New Hampshire Spine Institute	United States	Not reported
Weiner, Walker, Brower et al., 1999	30	1996-1997	Single	Spinal Unit, Northeastern Ohio Universities, College of Medicine	United States	Not reported
diPierro, Helm, Shaffrey et al., 1996	35	1990-1992	Single	Virginia Neurological Institute, University of Virginia Health Sciences Center	United States	Not reported
Retrospective Trial with Consecutive Patients
Vitaz, Raque, Shields et al., 1999	65	1990-1996	Single	University of Louisville School of Medicine	United States	Not reported
Matsui, Kanamori, Ishihara et al., 1997	27	1984-1992	Single	Toyama Medical and Pharmaceutical University	Japan	Not reported
Airaksinen, Herno, Turunen et al., 1997	497	1974-1988	Single	Kuopio University Hospital	Finland	Not reported
Mullin, Rea, Irsik et al., 1996	72	1986-1990	Single	The Ohio State University	United States	Not reported
Ishac, Alhayek, Fournier et al., 1996	34	1979-1994	Single	Teaching Hospital Angers France	France	Not reporting
Jonsson and Stromqvist, 1994	43	1991-1992	Single	University Hospital Lund	Sweden	Sewdish Medical Research Council
Caputy and Luessenhop, 1992	100	1980-1984	Single	Georgetown University Medical Center	United States	Not reported
Dhar and Porter, 1992	36	1980-1984	Single	Doncaster Royal Infirmary	England	Not reported
Chahal, Mundkur, Sancheti et al., 1982	32	1978-1980	Single	Armed Forces Medical College	India	Not reported
Rosomoff, 1981	50	1972-1980	Single	University of Miami School of Medicine	United States	Not reported
Getty, 1980	35	1968-1978	Single	Nordolk and Norwich Hospital	England	Not reported
Reale, Deifini, Gambacona et al., 1978	37	1974-1976	Single	University of Siena	Italy	Not reported
Verbiest, 1977	116	1948-1976	Single	University of Utrecht	Netherlands	Not reported
Case-series
Young, Veerapen, and O'Laoire, 1988	32		Multiple <5	National Neurosurgery Centre and Richmond Institute of Neurology and Neurosurgery, Beaumont Hospital, Dublin, Eire	Ireland
Kurihara, Tanaka, Tsumura et al., 1988	12	1966-1984	Single	Kobe Rosai Hospital, Kobe, Japan	Japan
Hall, Bartleson, Onofrio et al., 1985	68	1978-1980	Single	Mayo Clinic and Mayo Foundation, Rochester, MN, United States	United States
Weinstein, Scafuri, and McNeill, 1983	24	1976-1980	Single	Rush-Presbyterian St. Luke's Medical Center	United States	Not reported
Weir and De Leo, 1981	81	1968-1980	Single	University of Alberta	Canada	Not reported
Johnsson, Willner, and Pettersson, 1981	27	1973-1980	Single	Malmo General Hospital, Sweden	Sweden
Verbiest, 1979	11	1960-1976	Single	State University of Utrecht, Utrecht, The Netherlands	Netherlands
Salibi, 1976	20	1970-1974	Single	Marshfield Clinic and Marshfield Medical Foundation, Inc., Marshfield, Wisconsin, United States	United States
Trials Examining Surgical Patients with Lateral Lumbar Stenosis
Randomized controlled Trial
Lee and deBari, 1986	24	1977-1984	Single	New Jersey Medical School	United States	Not reported
Controlled Trials
Kirkaldy-Willis, Wedge, Yong-Hing et al., 1982	94	1967-1978	Single	University Hospital, Saskatoon	Canada	Not reported
Mikhael, Ciric, Tarkington et al., 1981	85	1976-1980	Single	Evanston Hospital, Northwestern University	United States	Not reported
Retrospective Trial with Consecutive Patients
Sanderson and Getty, 1996	66	1982-1988	Single	Northern General Hospital	England	Not reported
Baba, Uchida, Maezawa et al., 1996	31	1988-1996	Single	Fuku Medical School	Japan	Not reported
Aryanpur and Ducker, 1990	32	1985-1988	Single	John Hopkins Hospital	United States	Not reported
Case-series
Choudhury and Taylor, 1977	28	1974-1976	Single	Derbyshire Royal Infirmary, Derby, England	England
Epstein, Epstein, Rosenthal et al., 1972	15	1967-1972	Single	Long Island Jewish Medical Center, New Hyde Park, New York, United States	United States
Trials Examining Surgical Patients with Central or Lateral Lumbar Stenosis type of stenosis unspecified or includes bothtypes of stenosis
Controlled Trial
Yone and Sakou, 1999	60	1986-1996		Kagoshima University, Jakgshima, Japan	Japan
Epstein, 1999	21	1986-1996	Single	North Shore University Hospital, Manhasset, NY, United States	United States
Javid and Hadar, 1998	170	1984-1996	Single	University of Wisconsin Hospital and Clinics	United States	Not reported
Kalbarczyk, Lukes, and Seiler, 1998	148		Single	Inselspital, Bern, Switzerland	Switzerland
Pai and Kumar, 1996	55	1980-1984	Single	Kasturba Medical College, Manipal, Karnataka, India	India
Kawauchi, Yone, and Sakou, 1996	36	1990-1996	Single	Kagoshima University	Japan
Cinotti, Postacchini, and Weinstein, 1994	50		Multiple <5	Orthoaedic Clinic, University of Rome	Italy and the United States	No funds from commercial party.
Little and MacDonald, 1994	94	1987-1992	Single	Sydney Adventist Hospital	Australia	Not reported
Simpson, Silveri, Balderston et al., 1993	57	1982-1988	Single	Tuckahoe Orthopaedic Associates and The Rothman Institute, Pennsylvania Hospital	United States	No funds were received in support of this study.
Jonsson and Stromqvist, 1993a	39		Single	University Hospital Lund	Sweden	Swedish Medical Research Council, Medical Faculty of Lund, the Thelma Aoegas Fund
Nasca, 1989	114	1979-1986	Single	University of Alabama at Birmingham, Birmingham, Alabama, United States	United States
Nather and Thomas, 1985	34	1973-1980	Single	Singapore General Hospital	Singapore
Paine, 1976	143		Single	University Hospital, Saskatoon, Saskatchewan, Canada
Shenkin and Hash, 1976	49	1968-1972	Single	Episcopal Hospital	United States	Not reported
Tile, McNeil, Zarins et al., 1976	26	1957-1974	Single	St. Joseph's Hospital	Canada	Not reported
Retrospective Trial with Consecutive Patients
Crock, Shiraishi, and Crock, 1995	34	1988-1992	Single	Spinal Disorder Unit, Cromwell Hospital	United Kingdom	Not reported
Silvers, Lewis, and Asch, 1993	248	1978-1992	Single	Southtowns Neurological Surgeons Association, Buffalo, NY	United States	Not reported
Katz, Lipson, Larson et al., 1991	88	1983-1986	Single	Bringham and Women's Hospital, Robert B. Brigham Multipurpose Arthritis Center	United States	NIH grant
Ganz, 1990	36	1981-1986	Single	Haukeland Hospital	Norway	Not reported
Case-series
Norcross-Nechay, Mathew, Simmons et al., 1999	70	1996-1996	Single	University of Texas Medical Branch, Galveston, TX, United States	United States
Guigui, Benoist, Delecourt et al., 1998	50			Hospital Beaujon, Clichy, France	France
Scholz, Firsching, and Lanksch, 1998	72	1987-1990	Single	Free University of Berlin	Germany
Tsai, Yang, and Bray, 1998	62		Single	Garfield Medical Center, Monterey Park, CA, United States	United States
Mackay and Wheelwright, 1998	50	1992-1996	Single	Stobhill Hospital, Glasgow, UK	UK
Whitecloud, Castro Jr, Brinker et al., 1998	35	1993-1994	Multiple <5	Tulane University School of Medicine, New Orleans, LA, United States	United States
Spetzger, Bertalanffy, Reinges et al., 1997	29		Single	Technical University of Aachen, Aachen, Federal Republic of Germany	Germany
Katz, Lipson, Chang et al., 1996	88	1983-1986	Multiple <5	Brigham and Women's Hospital	United States	NIH Grant#AR36308, a Summer Medical Student Research Grant from the American College of Rheumatology
Lehto and Honkanen, 1995	96	1980-1988	Single	Tampere University, Tampere, Finland	Finland
Stucki, Liang, Fossel et al., 1995	230		Multiple <5	University of Zurich, Zurich, Switzerland	Switzerland
Tuite, Stern, Doran et al., 1994	380	1983-1990	Multiple <5	University of Michigan Hospital	United States
McCullen, Bernini, Bernstein et al., 1994	193	1980-1992		Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States	United States
Simmons and Simmons, 1992	40		Single	Buffalo General Hospital	United States	Not reported
Mauersberger and Nietgen, 1989	92	1979-1986	Multiple <5	University Hospital, Bonn, Germany	Germany
Johnsson, Redlund-Johnell, Uden et al., 1989	61	1972-1986		Malmo General Hospital, Lund University, Malmo, Sweden	Sweden
Brodsky, Hendricks, Khalil et al., 1989	36		Single	Baylor College of Medicine, Houston, TX, United States	United States
Jalovaara, Lahde, Iikko et al., 1989	31	1978-1982	Single	University of Oulu, Finland	Finland
Fast, Robin, and Floman, 1985	19	1980-1984	Multiple <5	Ichilov Hospital, Tel Aviv Medical Center, Tel Aviv, Israel	Israel
Boccanera, Pellicioni, and Laus, 1984	25	1977-1981	Single	Traumatical and Orthopaedic Centre, Bologna	Italy
Hood and Weigl, 1983	21	1975-1980	Single	Hasharon Hospital	Israel
Scafuri and Weinstein, 1981	27	1977-1980	Single	Rush-Presbyterian-St. Luke's Medical Center	United States	Not reported
Echeverria and Lockwood, 1979	35	1966-1976	Single	Upstate Medical Center, Syracuse, NY, United States	United States
Scapinelli, 1978	23	1966-1978	Single	Unicersita degli Studi di Chieti, Chieti, Italy	Italy
Vestad and Naca, 1977	80	1955-1970	Single	Sophies Minde Orthopaedic Hospital, University of Oslo, Oslo, Norway	Norway
McKinley and Davis, 1976	32	1963-1972	Single	Ochsner Clinic, New Orleans, LA, United States	United States
Teng and Papatheodorou, 1963	29		Single	The Kaiser Foundation Hospitals	United States
Epstein, Epstein, and Lavine, 1962	29		Single	Long Island Jewish Hospital, New Hyde Park, NY, United States	United States
Epstein, 1960	14		Single	Long Island Jewish Hospital, New Hyde Park, NY, United States	United States
Trials Examining Surgical Patients with Degenerative Spondylolisthesis
Randomized controlled Trial
Fischgrund, Mackay, Herkowitz et al., 1997	75		Single	William Beaumont Hospital	Michigan, United States	No funds were received in support of this study.
Thomsen, Christensen, Eiskjaer et al., 1997	41	1992-1994	Multiple <5	University Hospital of Aarhus	Denmark	The Danish Rheumatism Association and Arosia Spine Research Foundation
Bridwell, Sedgewick, O'Brien et al., 1993	43	1985-1990	Single	Washington University School of Medicine, St. Louis	United States	No outside funding
Herkowitz and Kurz, 1991	50		Single	William Beaumont Hospital	United States	No funds were received in support of this study
Controlled Trials
Plotz and Benini, 1998	106	1979-1992		Schulthess Clinic, Zurich, Switzerland	Switzerland
Yuan, Garfin, Dickman et al., 1994	2684	1990-1992	Multiple >5	State University of New York	United States, Canada, Europe	FDA
Satomi, Hirabayashi, Toyama et al., 1992	41	1981-1988	Single	Keio University School of Medicine	Japan	Not reported
Lombardi, Wiltse, Reynolds et al., 1985	47	1971-1984	Single	Memorial Hospital Medical Center of Long Beach, California, United States	United States
Prospective Trials
Nakai, Yoshizawa, and Kobayashi, 1999	23	1986-1992	Single	Fujita Health University	Japan	Not reported
Rechtine, Sutterlin, Wood et al., 1996	18	1989-1990	Multiple <5	Florida Orthopedic Institute	United States	Sofamor Danek United States; maker of the pedicle/screw system used in the trial
Retrospective Trial with Consecutive Patients
Stambough, 1999	35	1986-1994	Single	Back Treatment Center, Deaconess Hospital, Cincinnati	United States	Not reported
Nishizawa and Fujimura, 1997	58	1982-1992	Single	Keio University School of Medicine	Japan	Not reported
Moller, Wittenberg, Nolte et al., 1992	37	1981-1992	Single	Department of Surgery, Augusta-Krankenanstallen	Germany	Not reported
Marchesi, Thalgott, and Aebi, 1991	30	1984-1988	Multiple <5	University of Bern	Switzerland and United States
Takahashi, Kitahara, Yamagata et al., 1990	39	1958-1988	Single	Chiba University School of Medicine	Japan	Not reported
Knox, Harvell, Nelson et al., 1989	39	1983-1988	Single	Orthopaedic Surgery and Neurosurgery, University of Pittsburgh	United States	Not reported
Case-series
Booth, Bridwell, Eisenberg et al., 1999	49		Single	Washington University School of Medicine, St. Louis, Missouri, United States	United States
McCulloch, 1998	21	1993-1996	Single	Northeastern Ohio Universities College of Medicine, Rootstown OH, United States	United States
Epstein, 1998b	28	1991-1996	Single	North Shore University Hospital, Manhasset, NY, United States	United States
Mochida, Toh, Suzuki et al., 1997	10	1990-1996	Single	Tokai University School of Medicine, Kanagawa, Japan	Japan
Epstein, 1998a	290	1966-1996	Multiple <5	Cornell University Medical College, Ithaca, NY, United States	United States
Grob, Humke, and Dvorak, 1996	18	1987-1992	Single	Schulthess Hospital, Zurich, Switzerland	Switzerland
Herron and Trippi, 1989	24	1980-1986	Single	Central Coast Spine Institute, San Luis Obispo, CA, United States	United States
Chang and McAfee, 1989	17		Single	803 Army General Hospital, Taiwan, R.O.C.	United States
Inoue, Watanabe, Goto et al., 1988	36	1958-1984	Single	School of Medicine, Chiba University, Chiba, Japan	Japan
Simmons and Capicotto, 1988	15		Single	State University of New York at Buffalo and Buffalo General Hospital, Buffalo, NY, United States	United States
Hanley, 1986	20			University of Pittsburgh, Pittsburgh, PA, United States	United States
Kaneda and Kazama, 1986	54	1978-1984	Single	Hokkaido University School of Medicine, Sapporo, Japan	Japan
Alexander Jr, Kelly Jr, Davis Jr et al., 1985	50	1972-1984	Single	Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC, United States	United States
Dall and Rowe, 1985	26	1977-1980	Multiple <5	Michigan State University, Kalamazoo, MI, United States	United States
Epstein, Epstein, Carras et al., 1983	60	1971-1982	Single	Long Island Jewish-Hillside Medical Center	United States	Not reported
Richardson and Brown, 1980	21	1976-1980	Single	Piedmont Hospital and Georgia Baptist Hospital	United States	Not reported
Cauchoix, Benoist, and Chassaing, 1976	26		Single	Clinique Orthopedique de l'Hopital Boujon. Faculte de Medecine Xavier Bichat, Universite de Paris, VIII, Paris, France	France
Epstein, Epstein, Lavine et al., 1976	20	1965-1974	Single	Long Island Jewish Hospital, New Hyde Park, NY, United States	United States
Trials Examining Surgical Patients with Lumbar Stenosis and/or Degenerative Spondylolisthesis
Controlled Trial
Rompe, Eysel, Zollner et al., 1999	117	1987-1992	Single	Johannes Gutenberg Medical School	Germany	Not reported
Katz, Lipson, Lew et al., 1997	272	1989-1992	Multiple >5	Brigham and Women's Hospital, Boston, Massachusetts	United States	NIH grant and an Arthritis Foundation Investigator award to Dr. Katz
Sato and Kikuchi, 1997	81	1989-1996	Single	Fukushima Medical College, Japan	Japan	Fukushima Society for the Promotion of Medicine
Rompe, Eysel, Hopf et al., 1995	60	1986-1992	Single	Johannes Gutenberg University Hospital, Mainz, Federal Republic of Germany	Germany
Sanderson and Wood, 1993	34	1984-1988	Single	Wrightington Hospital	England	Not reported
Robertson, Grobler, Novotny et al., 1993	33		Multiple <5	McClure Musculoskeletal Research Center, Spine Institute of New England	United States	Spine Institute of New England Surgeons Research Fund, Arthritis Foundation, NIH grant
Postacchini, Cinotti, Perugia et al., 1993	70	1987-1992	Single	University of Modena	Italy	Not reported
Hirabayashi, Kumano, and Kuroki, 1991	53	1986-1988	Single	Kantoh Rosai Hospital	Japan	Not reported
Herkowitz and Garfin, 1989	99		Single	William Beaumont Hospital, Royal Oak, MI, United States	United States
Prospective Trials
Jonsson, Annertz, Sjoberg et al., 1997a	105	1986-1992	Single	Lund University Hospital, Lund, Sweden	Sweden	Swedish Medical Research Council
Postacchini and Conotti, 1992	88	1972-1984	Single	University of Modena	Italy	Not reported
Retrospective Trial with Consecutive Patients
Chen, Baba, Kamitani et al., 1994	80	1983-1990	Single	Fukui Medical School	Japan	Not reported
Postacchini, Cinotti, Gumina et al., 1993	64	1972-1988	Multiple <5	University of Modena	Italy	Not reported
Case-series
Guigui, Barre, Benoist et al., 1999	28	1984-1988	Single	Hospital Beaujon	France	Not reported
Trials Examining Surgical Patients and Patients Receiving Conservative Treatment
Patients with Central Lumbar Stenosis
Simotas, Dorey, Hansraj et al., 2000	55	1992-1998	Single	Physical Medicine and Rehabilitation Service, Hospital for Special Surgery, NY	United States	Not reported
Mariconda, Zanforlino, Celestino et al., 2000	37	1994-1996	Single	University of Catanzaro Magna Graecia School of Medicine	Italy	Not reported
Johnsson, Uden, and Rosen, 1991	76	1974-1984	Single	Malmo General Hospital, Lund University	Sweden	Herman Jamhardt, Greta and Johan Kock, and Alfred Osterlund Foundation
Patients with Central or Lateral Lumbar Stenosis Unspecified
Amundsen T, Weber H, Nordal HJ et al., 2000	100	1984-1996	Single	Ulleval Hospital, Oslo, Norway	Norway	Clinical Research Forum, Ulleval University Hospital, Oslo, Norway
Hurri, Slatis, Soini et al., 1998	134	1978-1982	Single	Orthopaedic Hospital of the Invalid Foundation	Finland	Not reported
Atlas, Deyo, Keller et al., 1996	148	1990-1992	Multiple >5	Massachusetts General Hospital, Harvard Medical School	United States	Agency for Health Care Policy and Research grant
Atlas, Keller, Robson et al., 2000	119	Four year followup of Atlas, Deyo, Keller et al., 1996
Swezey, 1996	47	1986-1988	Single	Arthritis and Back Pain Center, Swezey Institute	United States	Not Reported
Nagler and Bodack, 1993	100	1980-1983	Single	The New York Hospital - Cornell University	United States	Not reported
Herno, Airaksinen, Saari et al., 1996	57	1980-1988	Single	Kuopio University Hospital	Finland	Not reported
Patients with Degenerative Spondylolisthesis
Fitzgerald and Newman, 1976	43	1953-1970	Single	Spinal Research Unit, Royal National Orthopaedic Hospital	England	Not reported
Rosenberg, 1976	200	1956-1968	Single	Mount Sinai Hospital, Cleveland	United States	Not reported
Trials Describing Only the Natural History of Lumbar Spinal Stenosis Patients
Patients with Central Lumbar Stenosis
Hamdan and Al-Kaissie, 1994	75	1990-1992	Single	Basrah University Hospital	Iraq	Not reported
Patients with Lateral Lumbar Stenosis
Jonsson and Stromqvist, 1993b	100	1986-1992	Single	Lund University Hospital	Sweden	Swedish Medical Research Council
Patients with Degenerative Spondylolisthesis
Matsunaga, Sakou, Morizono et al., 1990	40	1975-1990	Single	Kagoshima University	Japan	Not reported
Sato, Wakamatsu, Yoshizumi et al., 1989	355	1983-1984	Single	Akita University School of Medicine	Japan	Not reported
Patients with Lumbar Stenosis and Spondylolisthesis
Radu and Menkes, 1998	62	1995-1996	Single	School of Medicine of the Sao Paulo University	France	Conselho Nacional de desenvolvimento Cientifico e tecnologico CNPq
Amundsen, Weber, Lilleas et al., 1995	100	1984-1988	Single	Ulleval Hospital, Oslo	Norway	Not reported
Johnsson, Uden, and Rosen, 1992	32	1981-1988	Single	Malmo General Hospital, Lund University, Malmo, Sweden	Sweden

Evidence Table 7. Specific Study Design Information for Clinical Trials of Patients with Lumbar Spinal Stenosis

Randomized controlled Trials of Patients Receiving Conservative Treatments
First Author and Year of Publication	Number of Patients in the Trial	Imaging Method Used in Study	Randomization Method	Blinding Method	Described Dropouts and Withdrawals	Reported Prior Conservative Treatment
Patients with Central or Lateral Lumbar Stenosis type of stenosis unspecified or includes both types of stenosis
Fukusaki, Kobayashi, Hara et al., 1998	53	MRI/CT	Not Stated	Investigator only	Yes	Not reported
Eskola, Pohjolainen, Alaranta et al., 1992	39	X-ray Myelography and CT	Men and women were randomized separately. Method not stated.	Double	No	Not reported
Cuckler, Bernini, Wiesel et al., 1985	37		Not Stated	Double	No	At least 2 weeks
Patients with Degenerative Spondylolisthesis
Sinaki, Lutness, Ilstrup et al., 1989	48	Plain radiograph	Not reported	Open	No	Not reported
Trials Examining Surgical Patients with Central Lumbar Stenosis
Randomized controlled Trial
Grob, Humke, and Dvorak, 1995	45	Plain radiograph, X-ray Myelography, CT, and MRI	Randomly assigned on the basis of the day of admission to the hospital.	Investigator only	Yes	Not reported
Controlled Trials
Herno, Saari, Suomalainen et al., 1999	92	Computerized Tomography CT	None	Double	No	Not reported
Herno, Partanen, Talaslahti et al., 1999	80	X-ray Myelography and CT	None	Double	Yes	Not reported
Hanakita, Suwa, and MIzuno, 1999	164	Plain radiograph	None	Open	No	Not reported
Thomas, Rea, Pikul et al., 1997	38	Plain radiograph and MRI	None	Investigator only	Yes	Not reported
Yone, Sakou, Kawauchi et al., 1996	34	X-ray Myelography, CT, and MRI	None	Open	No	Not reported
Ray, 1982	65	Computerized Tomography CT	None	Open	No	Not reported
Surin, Hedelin, and Smith, 1982	22	X-ray Myelography	none	none	No	Not reported
Tajima, Fukazawa, and Ishio, 1980	27	Plain radiograph	None	Open	No	Not reported
Prospective Trials
Kleeman, Hiscoe, and Berg, 2000	54	MRI/CT	None	Investigator only	Yes	Yes
Weiner, Walker, Brower et al., 1999	30	MRI/CT	None	Investigator only	Yes	Yes
diPierro, Helm, Shaffrey et al., 1996	35	X-ray Myelography and CT	None	Investigator only	Yes	Not reported
Retrospective Trial with Consecutive Patients
Vitaz, Raque, Shields et al., 1999	65	Plain radiograph and X-ray Myelography	None	Open	Yes	Adequate trial
Matsui, Kanamori, Ishihara et al., 1997	27	Plain radiograph, X-ray Myelography, and CT	None	Open	No	Not reported
Airaksinen, Herno, Turunen et al., 1997	497	X-ray Myelography and CT	None	Double	Yes	Not reported
Mullin, Rea, Irsik et al., 1996	72	Plain radiograph	None	Investigator only	Yes	Not reported
Ishac, Alhayek, Fournier et al., 1996	34	X-ray Myelography and CT	None	Open	No	Not reported
Jonsson and Stromqvist, 1994	43	Plain radiograph, X-ray Myelography, CT, and MRI	None	Investigator only	Yes	Not reported
Caputy and Luessenhop, 1992	100	X-ray Myelography	None	Investigator only	Yes	1 month to 12 years
Dhar and Porter, 1992	36	Plain radiograph and CT	None	Open	No	Not reported
Chahal, Mundkur, Sancheti et al., 1982	32	Plain radiograph and X-ray Myelography	None	Open	No	Some months
Rosomoff, 1981	50	Plain radiograph, and X-ray Myelography	None	Open	No	Not reported
Getty, 1980	35	Plain radiograph and X-ray MyelographyI	None	Open	Yes	Some period of conservative treatment
Reale, Deifini, Gambacona et al., 1978	37	X-ray Myelography	None	Open	Yes	Not reported
Verbiest, 1977	116	X-ray Myelography	None	Open	Yes	Not reported
Case-series
Young, Veerapen, and O'Laoire, 1988	32	X-ray Myelography and CT	None	Open	No	Not reported
Kurihara, Tanaka, Tsumura et al., 1988	12	Plain radiograph	None	Open	No	Not reported
Hall, Bartleson, Onofrio et al., 1985	68	X-ray Myelography and CT	None	Open	Yes	Not reported
Weinstein, Scafuri, and McNeill, 1983	24	Plain radiograph, X-ray Myelography, and CT	None	Investigator only	No	Not reported
Weir and De Leo, 1981	81	X-ray Myelography and CT	None	Open	No	Not reported
Johnsson, Willner, and Pettersson, 1981	27	Plain X-ray, X-ray Myelography, and CT	none	none	No	Not reported
Verbiest, 1979	11	Plain radiograph	None	Open	No	Not reported
Salibi, 1976	20	X-ray Myelography	None	Open	Yes	Not reported
Trials Examining Surgical Patients with Lateral Lumbar Stenosis
Randomized controlled Trial
Lee and deBari, 1986	24	Plain radiograph	No method reported	Open	No	Not reported
Controlled Trials
Kirkaldy-Willis, Wedge, Yong-Hing et al., 1982	94	Plain radiograph	None	Open	No	Not reported
Mikhael, Ciric, Tarkington et al., 1981	85	Plain radiograph, X-ray Myelography, and CT	None	Open	No	Not reported
Retrospective Trials with Consecutive Patients
Sanderson and Getty, 1996	66	Computerized Tomography CT	None	Investigator only	Yes	Not reported
Baba, Uchida, Maezawa et al., 1996	31	Plain radiograph, CT, and MRI	None	Investigator only	No	Not reported
Aryanpur and Ducker, 1990	32	MRI/CT	None	Open	No	Not reported
Case-series
Choudhury and Taylor, 1977	28	X-ray Myelography	None	Open	No	Not reported
Epstein, Epstein, Rosenthal et al., 1972	15	X-ray Myelography	None	Open	No	Not reported
Trials Examining Surgical Patients with Centralor Lateral Lumbar Stenosis type of stenosis unspecified or includes both types of stenosis
Controlled Trial
Yone and Sakou, 1999	60	X-ray Myelography, CT, and MRI	None. Patients with instability received fusion or not by their own choice.	Open	No	Not reported
Epstein, 1999	21	X-ray Myelography and CT	None	Open	No	Not reported
Javid and Hadar, 1998	170	CT myelography scanning and/or MRI	None	Open	Yes	Not reported
Kalbarczyk, Lukes, and Seiler, 1998	148	X-ray Myelography, CT, and MRI	None	Open	Yes	Not reported
Pai and Kumar, 1996	55	Plain radiograph	None	Open	Yes	At least 3 months
Kawauchi, Yone, and Sakou, 1996	36	X-ray Myelography and myeloscopy	none	none	No	Reported but no time period provided.
Cinotti, Postacchini, and Weinstein, 1994	50	X-ray Myelography, CT, and MRI	None	Open	Yes	At least 3 months
Little and MacDonald, 1994	94		None	Open	No	Not reported
Jonsson and Stromqvist, 1993a	39	Plain radiograph, X-ray Myelography, CT, and MRI	None	Open	Yes	Not required
Nasca, 1989	114	X-ray Myelography and CT	None	Open	No	Not reported
Nather and Thomas, 1985	34	X-ray Myelography	None	Open	No	Not reported
Paine, 1976	143	X-ray Myelography	None	Open	No	Not reported
Shenkin and Hash, 1976	49	X-ray Myelography	None	Open	Yes	Not reported
Tile, McNeil, Zarins et al., 1976	26	Plain radiograph	None	Investigator only	Yes	Not reported
Retrospective Trial with Consecutive Patients
Crock, Shiraishi, and Crock, 1995	34	Plain radiograph and MRI	None	Open	No	All patients failed to respond, not time reported
Simpson, Silveri, Balderston et al., 1993	57	X-ray Myelography, CT, and MRI	None	Investigator only	Yes	Not reported
Silvers, Lewis, and Asch, 1993	248	X-ray Myelography, CT, and MRI	None	Open	Yes	1 month to several years
Katz, Lipson, Larson et al., 1991	88	Plain radiograph, X-ray Myelography and CT	None	Investigator only	Yes	Not reported
Ganz, 1990	36	X-ray Myelography	None	Open	Yes	Not reported
Case-series
Norcross-Nechay, Mathew, Simmons et al., 1999	70		None	Open	No	Not reported
Guigui, Benoist, Delecourt et al., 1998	50	X-ray Myelography, CT, and MRI	None	Open	No	Not reported
Scholz, Firsching, and Lanksch, 1998	72	X-ray Myelography, CT, and MRI	None	Open	No	Not reported
Tsai, Yang, and Bray, 1998	62	X-ray Myelography, CT, and MRI	None	Open	No	Not reported
Mackay and Wheelwright, 1998	50	X-ray Myelography, CT, and MRI	None	Open	Yes	Not reported
Whitecloud, Castro Jr, Brinker et al., 1998	35	X-ray Myelography, CT, and MRI	None	Open	No	Not reported
Spetzger, Bertalanffy, Reinges et al., 1997	29	X-ray Myelography, CT, and MRI	None	Open	No	Not reported
Katz, Lipson, Chang et al., 1996	88	X-ray Myelography, CT, and MRI	None	Open	Yes	Not reported
Lehto and Honkanen, 1995	96	X-ray Myelography and CT	None	Open	Yes	Not reported
Stucki, Liang, Fossel et al., 1995	230	X-ray Myelography, CT, and MRI	None	Open	Yes	Not reported
Tuite, Stern, Doran et al., 1994	380	MRI/CT	None	Open	No	Not reported
McCullen, Bernini, Bernstein et al., 1994	193	X-ray Myelography and CT	None	Open	No	Not reported
Simmons and Simmons, 1992	40	Plain radiograph	None	Open	Yes	Not reported
Mauersberger and Nietgen, 1989	92	X-ray Myelography and CT	None	Open	Yes	Not reported
Johnsson, Redlund-Johnell, Uden et al., 1989	61	X-ray Myelography	None	Open	No	Not reported
Brodsky, Hendricks, Khalil et al., 1989	36	Computerized Tomography CT	None	Open	No	Not reported
Jalovaara, Lahde, Iikko et al., 1989	31	X-ray Myelography and CT	none	none	No	Not reported
Fast, Robin, and Floman, 1985	19	X-ray Myelography and CT	None	Open	No	Not reported
Boccanera, Pellicioni, and Laus, 1984	25	X-ray Myelography and CT	None	Open	No	Not reported
Hood and Weigl, 1983	21	X-ray Myelography	None	Open	Yes	Not reported
Scafuri and Weinstein, 1981	27	X-ray Myelography and CT	None	Open	No	Not reported
Echeverria and Lockwood, 1979	35	X-ray Myelography	None	Open	No	Not reported
Scapinelli, 1978	23	X-ray Myelography	None	Open	No	Not reported
Vestad and Naca, 1977	80	Plain radiograph	None	Open	No	Not reported
McKinley and Davis, 1976	32	X-ray Myelography	None	Open	No	Not reported
Teng and Papatheodorou, 1963	29	X-ray Myelography	None	Open	No	Not reported
Epstein, Epstein, and Lavine, 1962	29	X-ray Myelography	None	Open	No	Not reported
Epstein, 1960	14	X-ray Myelography	None	Open	No	Not reported
Trials Examining Surgical Patients with Degenerative Spondylolisthesis
Randomized controlled Trial
Fischgrund, Mackay, Herkowitz et al., 1997	75	Plain radiograph, X-ray Myelography, CT, and MRI	Withdrawal of card from envelope performed by assistant not the treating physician.	Investigator only	Yes	At least 3 months
Thomsen, Christensen, Eiskjaer et al., 1997	41	Plain radiograph, X-ray Myelography, CT, and MRI	20 number per block randomization procedure with two surgical procedures concealed in two envelopes.	Double	Yes	Not reported
Bridwell, Sedgewick, O'Brien et al., 1993	43	X-ray Myelography, CT, and MRI	Not described.	Double	No	Not reported
Herkowitz and Kurz, 1991	50	Plain radiograph, X-ray Myelography, CT, and MRI	Assigned alternately	Open	Yes	Not reported
Controlled Trials
Plotz and Benini, 1998	106	X-ray Myelography	None	Open	No	Not reported
Yuan, Garfin, Dickman et al., 1994	2684	Plain radiograph	None	Open	Yes	Not reported
Satomi, Hirabayashi, Toyama et al., 1992	41	Plain radiograph, X-ray Myelography, and CT	None	Open	No	Not reported
Lombardi, Wiltse, Reynolds et al., 1985	47	X-ray Myelography and CT	None	Open	No	Not reported
Prospective Trials
Nakai, Yoshizawa, and Kobayashi, 1999	23	Plain radiograph	None	Open	Yes	Not reported
Rechtine, Sutterlin, Wood et al., 1996	18	Plain radiograph	None	Investigator only	Yes	Not reported
Retrospective Trial with Consecutive Patients
Stambough, 1999	35	Plain radiograph and CT	None	Investigator only	No	6 weeks to 16 years
Nishizawa and Fujimura, 1997	58	Plain radiograph, X-ray Myelography, and CT	None	Open	No	Not reported
Moller, Wittenberg, Nolte et al., 1992	37	Plain radiograph, CT, and MRI	None	Open	Yes	At least 1 year
Marchesi, Thalgott, and Aebi, 1991	30	Plain radiograph	None	Open	No	Not reported
Takahashi, Kitahara, Yamagata et al., 1990	39	Plain radiograph, X-ray Myelography, and CT	None	Open	Yes	Not reported
Knox, Harvell, Nelson et al., 1989	39	Plain radiograph and X-ray Myelography	None	Open	Yes	Not reported
Case-series
Booth, Bridwell, Eisenberg et al., 1999	49	Plain radiograph	None	Open	No	Not reported
McCulloch, 1998	21	MRI/CT	None	Open	No	Not reported
Epstein, 1998b	28	X-ray Myelography, CT, and MRI	None	Open	No	Not reported
Mochida, Toh, Suzuki et al., 1997	10	X-ray Myelography	none	Open	No	Not reported
Epstein, 1998a	290	X-ray Myelography, CT, and MRI	None	Open	No	Not reported
Grob, Humke, and Dvorak, 1996	18	X-ray Myelography and CT	None	Open	Yes	Not reported
Herron and Trippi, 1989	24	X-ray Myelography and CT	None	Open	No	Not reported
Chang and McAfee, 1989	17	X-ray Myelography	None	Open	No	Not reported
Inoue, Watanabe, Goto et al., 1988	36	X-ray Myelography	None	Open	No	Not reported
Simmons and Capicotto, 1988	15	X-ray Myelography and CT	Not Stated	Open	No	Not reported
Hanley, 1986	20	X-ray Myelography and CT	None	Open	No	Not reported
Kaneda and Kazama, 1986	54	X-ray Myelography and CT	None	Open	No	Not reported
Alexander Jr, Kelly Jr, Davis Jr et al., 1985	50	X-ray Myelography	None	Open	Yes	Not reported
Dall and Rowe, 1985	26	X-ray Myelography and CT	None	Open	Yes	Not reported
Epstein, Epstein, Carras et al., 1983	60	Plain radiograph, X-ray Myelography, and CT	None	Open	No	Not reported
Richardson and Brown, 1980	21	Plain radiograph	None	Open	Yes	Not reported
Cauchoix, Benoist, and Chassaing, 1976	26	X-ray Myelography	None	Open	No	Not reported
Epstein, Epstein, Lavine et al., 1976	20	X-ray Myelography	None	Open	No	Not reported
Trials Examining Surgical Patients with Lumbar Stenosis and/or Degenerative Spondylolisthesis
Controlled Trial
Rompe, Eysel, Zollner et al., 1999	117	X-ray Myelography, CT, and MRI	None	Open	Yes	Not reported
Katz, Lipson, Lew et al., 1997	272	X-ray Myelography, CT, and MRI	None	Investigator only	Yes	Not reported
Sato and Kikuchi, 1997	81		None	None	No	Not reported
Rompe, Eysel, Hopf et al., 1995	60	Computerized Tomography CT	None	Open	No	Not reported
Sanderson and Wood, 1993	34	X-ray Myelography and CT	None	Open	Yes	Not reported
Postacchini, Cinotti, Perugia et al., 1993	70	X-ray Myelography, CT, and MRI	Alternate assignment	Investigator only	Yes	Not reported
Robertson, Grobler, Novotny et al., 1993	33	MRI/CT	None	Open	No	Not reported
Hirabayashi, Kumano, and Kuroki, 1991	53	X-ray Myelography	None	Open	No	Not reported
Herkowitz and Garfin, 1989	99	X-ray Myelography, CT, and MRI	None	Open	No	Not reported
Prospective Trial
Jonsson, Annertz, Sjoberg et al., 1997a	105	X-ray Myelography, CT, and MRI	None	Investigator only radiologist only	Yes	Not reported
Postacchini and Conotti, 1992	88	Plain X-ray, CT, and MRI	None	Open	Yes	Not reported
Retrospective Trial with Consecutive Patients
Chen, Baba, Kamitani et al., 1994	80	X-ray Myelography	None	Investigator only	Yes	Not reported
Postacchini, Cinotti, Gumina et al., 1993	64	Plain X-ray, CT, and MRI	None	Open	No	Not reported
Case-series
Guigui, Barre, Benoist et al., 1999	28	Plain radiograph and CT	None	Investigator only	Yes	Not reported
Trials Examining Surgical Patients and Patients Receiving Conservative Treatment
Patients with Central Lumbar Stenosis
Simotas, Dorey, Hansraj et al., 2000	55	CT and MRI	None	Open	Yes	At least 6 weeks
Mariconda, Zanforlino, Celestino et al., 2000	37	Plain X-ray, CT, and MRI	None	Investigator only	Yes	Not reported
Johnsson, Uden, and Rosen, 1991	76	X-ray Myelography	None	Open	Yes	Not reported
Patients with Central or Lateral Lumbar Stenosis Unspecified
Amundsen, Weber, Nordal et al., 2000	100	Plain radiograph, X-ray Myelography, and CT	Block randomization using tables of random numbers	Open	Yes	No
Hurri, Slatis, Soini et al., 1998	134	X-ray Myelography	None	Investigator only	Yes	Not reported
Atlas, Deyo, Keller et al., 1996	148		None	Open	Yes	At least 2 weeks
Atlas, Keller, Robson et al., 2000	119	Four year followup to Atlas, Deyo, Keller et al., 1996
Swezey, 1996	47	MRI/CT	None	Open	Yes	Not reported
Nagler and Bodack, 1993	100	Computerized Tomography CT	None	Open	Yes	Not reported
Herno, Airaksinen, Saari et al., 1996	57	X-ray Myelography	None	Investigator only	Yes	Not reported
Patients with Degenerative Spondylolisthesis
Fitzgerald and Newman, 1976	43	Plain radiograph	None	Open	No	Not reported
Rosenberg, 1976	200	Plain radiograph	None	Open	No	Not reported
Trials Describing Only the Natural History of Lumbar Spinal Stenosis Patients
Patients with Central Lumbar Stenosis
Hamdan and Al-Kaissie, 1994	75	Plan X-ray and X-ray Myelography	None	Open	No	Reported but no time period was given
Patients with Lateral Lumbar Stenosis
Jonsson and Stromqvist, 1993b	100	Plain radiograph, X-ray Myelography, CT, and MRI	None	Open	No	Not reported
Patients with Degenerative Spondylolisthesis
Matsunaga, Sakou, Morizono et al., 1990	40	Plain radiograph	None	Open	No	Not required
Sato, Wakamatsu, Yoshizumi et al., 1989	355	Plain X-ray and Computerized Tomography CT	None	Open	No	Not reported
Patients with Lumbar Stenosis and Spondylolisthesis
Radu and Menkes, 1998	62	Plain radiograph, CT, and MRI	None	Open	No	Not required
Amundsen, Weber, Lilleas et al., 1995	100	Plain radiograph, X-ray Myelography, and CT	None	Investigator only	No	Not reported
Johnsson, Uden, and Rosen, 1992	32	X-ray Myelography	None	None	Yes	Not required

Evidence Table 8. Inclusion and Exclusion Criteria and Comments on Study Design for Clinical Trials of Patients with Lumbar Spinal Stenosis

Randomized controlled Trials of Patients Receiving Conservative Treatments
First Author and Year of Publication	Number of Patients in the Trial	Inclusion Criteria	Exclusion Criteria	Comments
Patients with Central or Lateral Lumbar Stenosis type of stenosis unspecified or includes both types of stenosis
Fukusaki, Kobayashi, Hara et al., 1998	53	Lumbar spinal stenosis with pseudoclaudication	Vascular claudication
Eskola, Pohjolainen, Alaranta et al., 1992	39	Back pain and pain radiating to the lower extremities, inability to walk more than 1500 meters on a treadmill.Sagittal diameter of lumbar spinal canal <10mm.	Vascular claudication. Patients receiving hormones, cardiovascular or hypertensive medication.	Trial originally included 40 patients.One was given the wrong dose of calcitonin at the beginning of treatment, and was excluded. Study has poor design. 2-month washout period was insufficient. Patient scores had not reverted to baseline.
Cuckler, Bernini, Wiesel et al., 1985	37	Neurogenic claudication, relieved by change in posture. Unrelieved by 2 weeks of bed rest and NSAIDS. Findings on tomography epidural veinography or myelography consistent with symptoms.	Evidence of compression of cauda equina or a progressive neural deficit. Patients with prior lumbar surgery excluded unless symptoms clearly different from pre-surgery and there was a 6-month symptom-free period.	Many 7-14 of 17 patients in the placebo group actually received treatment. Numbers are inconsistently reported.
Patients with Degenerative Spondylolisthesis
Sinaki, Lutness, Ilstrup et al., 1989	48	Nonsurgical patients with nontraumatic back pain and lumbar spondylolisthesis.	None Stated	3-month data is the same as Gramse, Sinaki, and Ilstrup, 1980 not in database, except for dropouts. No indication of whether all patients were reviewed, or just selected ones. Patient pain ratings were significantly different at baseline between groups.
Trials Examining Surgical Patients with Central Lumbar Stenosis
Randomized controlled Trial
Grob, Humke, and Dvorak, 1995	45	Degenerative spinal stenosis on the basis of history and clinical examination as well as CT scans after myelography or MRI.	Patients with obvious lumbar spine instability diagnosed on the basis of slip of a vertebrae more than 5 mm, spondylolysis with an osseous defect of the pars interarticularis, or previous operation on the lumbar spine.	Pain was measured but the location, back or leg, was not defined. The pain data was entered in the Back Pain Table. The levels of surgery were presented for the entire group of patients 5 single, 30 at two levels, and 10 at three levels.
Controlled Trials
Herno, Saari, Suomalainen et al., 1999	92	Preoperative diagnosis of lumbar spinal stenosis based on the patient's symptoms and signs leg pain, limited walking, neural deficits and confirmed by CT or myelography. Patients with no previous back surgery and had pre and post operative CT scans.	None reported.	Patients were divided post surgically into Stenosis and No Stenosis patients based on CT.
Herno, Partanen, Talaslahti et al., 1999	80	Patients treated surgically for lumbar spinal stenosis for the first time during the period 1982-1984 at Kuopio Hospital in Finland.	None reported	80 patients were operated on from 1982-1984, but only 56 patients were available for followup ten years later.These 56 patients were divided into Stenosis and No Stenosis groups based on an MRI evaluation at the 10 year followup.
Hanakita, Suwa, and MIzuno, 1999	164	Patients with lumbar canal stenosis surgically treated at the Department of Neurosurgery, Shizuoka General Hospital between 1990 and 1998. Patients received laminectomy plus fusion if the slip distance was over 10 mm or the slip angle was over 15 degrees.	None reported.	Too few patients older than 64 were included in the partial hemilaminectomy and laminectomy plus fusion groups to be extracted into the database. No preoperative patient information, including average ages, were reported.The age range was 19 to 84 years.76% of patients responded to the followup questionnaire, but dropouts are not reported for each patient group.The mean followup time for each patient group is not reported. The followup time could be anywhere from 1 to 8 years.
Thomas, Rea, Pikul et al., 1997	38	Diagnosed as having acquired lumbar spinal stenosis and subsequently underwent surgery between 1990 and 1993.	Significant degenerative spondylolisthesis requiring stabilization using pedicle or facet screws, underwent simultaneous lumbar discectomies, previous surgery for stenosis, prisoners, or history of schizophrenia.	This is a retrospective trial comparing two surgical approaches. Of 38 potential patients, 12 were not able to enter the study 3 dead, 7 distance or health problems, 2 not located.
Yone, Sakou, Kawauchi et al., 1996	34	Patients 60 years or older at time of surgery for lumbar spinal stenosis and were followed for more than 2 years.	Patients who had undergone multiple lumbar operations and those with spondylolysis or spondylolytic spondylolisthesis.	The study had three groups of patients based on preoperative instability and the type of surgery performed.The fusion group contained 10 patients, the nonfusion instability group had 7 patients, and the nonfusion noninstability group had 17 patients.
Ray, 1982	65	Patients in which the "wedge" procedures had been performed.	None reported.
Surin, Hedelin, and Smith, 1982	22	Patients operated on for lumbar spinal stenosis who were available for followup 22 of 33 patients; one patients died prior to followup.	Patients with previous lumbar spine surgery and spondylitic isthmic spondylolisthesis	Patients were group by degree of stenosis; Group 1: Marked AP diameter < or =10 mm, Group 2: AP diameter 11-14 mm. The number of surgical levels was not stratified by patient group: single level n=4, 2 levels n=12, more than 2 levels n=6.
Tajima, Fukazawa, and Ishio, 1980	27	Patients who had been surgically operated for lumbar disease at the Department of Orthopaedic Surgery of the Nagasaki Mitsubishi Hospital.	Patients with tumors, inflammatory diseases, and traumas.	Average age was estimated from data in a histogram.Patient data are part of a larger study examining the ligamentum flavum and spinal canal stenosis.Only immediate post-op results at approximately 3 months were reported.
Prospective Trials
Kleeman, Hiscoe, and Berg, 2000	54	Each patient had 1 neurogenic claudication as defined by leg pain limiting standing, ambulation, or both; 2 a history of exercise intolerance; 3 MRI or CT confirmation of compressive central stenosis with or without lateral recess stenosis; 4 failure of conservative therapy after an adequate trial.	Patients with 1 previous spinal surgery at the same level; 2 isthmic spondylolisthesis; 3 congenital spinal stenosis caused by short pedicles; and 4 an active workers' compensation claim or other litigation.	Prospective evaluation of the outcome of a decompressive procedure for lumbar spinal stenosis designed to preserve spinal stability. Procedure classified in the data base as a partial laminectomy. These patients could be considered severe based on their symptoms.
Weiner, Walker, Brower et al., 1999	30	Symptoms of neurogenic claudication referable to the lumbar spine brought on by walking or standing, relieved by sitting or flexing in the absence of vascular or neuropathic pathology.Failure of a minimum of 3 months of conservative treatment. MRI demonstrating neurological compression by hypertrophied ligamentum flavum, osteophytic facet joints, and annular bulging. Absence of associated pathology such as congenital stenosis, disc herniation, or spondylolisthesis.	None specified	This study describes a microdecompression technique categorized in the database as a partial laminectomy.
diPierro, Helm, Shaffrey et al., 1996	35	Symptomatic lumbar spinal stenosis, complained of low-back pain in addition to neurogenic claudication and/or radicular pain.None had obtained relief from conservative therapy.	None reported
Retrospective Trial with Consecutive Patients
Vitaz, Raque, Shields et al., 1999	65	Patients older than 75 years of age who underwent surgery for lumbar spinal stenosis secondary to spondylolisthesis at Norton Hospital in Louisville from November 1990 to May 1996.	None reported	All patients were older than 75 years.50 of 65 cases of decompression with fusion, 15 decompression only.
Matsui, Kanamori, Ishihara et al., 1997	27	Patients with degenerative lumbar stenosis who received expansive laminoplasty at the University Hospital between 1984 and 1995.	Patients whose age at operation was over 70 and patients with less than 2 years followup time.
Airaksinen, Herno, Turunen et al., 1997	497	Patients that under went surgery for lumbar spinal stenosis between 1974 and 1987 at Kuopio University Hospital.	None Reported	14 patients had developmental stenosis and 115 patients had a combination of developmental and degenerative stenosis.Extent of disease based on AP diameter of spinal canal.
Mullin, Rea, Irsik et al., 1996	72	Patients who had undergone decompressive lumbar laminectomy with medial facetectomy for lumbar spinal stenosis between 1986 and 1990.	None reported	72 patients could have entered the study, but losses due to death, medical reasons, and lost to followup prevented all but 37 from returning. Of these 37, 13 patients were excluded for undergoing a fusion at the time of the operation or subsequently. This left 24 in the study.
Ishac, Alhayek, Fournier et al., 1996	34	Patients 80 years or older who underwent surgery for spinal stenosis between 1979 and 1994.	Patients less than 80 years old.	All patients were 80 years or older.
Jonsson and Stromqvist, 1994	43	Patients older than 70 years who underwent decompressive surgery for central lumbar stenosis.	None
Caputy and Luessenhop, 1992	100	Patients who underwent surgery for symptoms of degenerative lumbar spinal stenosis at Georgetown University Hospital from 1980-1985.	None reported
Dhar and Porter, 1992	36	Patients who had spinal surgery between January 1980 and December 1984 at Doncaster Royal Infirmary.	None reported.	Very little patient information. Only patients reported as poor were examined in depth.
Chahal, Mundkur, Sancheti et al., 1982	32	Patients presented with low back pain, were diagnosed and operated on for lumbar canal stenosis.	None reported
Rosomoff, 1981	50	A series of 50 patients with continuing observation since the inception of the study in 1972 using neural arch resection.	None reported
Getty, 1980	35	Surgically treated for lumbar spinal stenosis at the Norfolk and Norwich Hospital between 1968 and 1978	None reported	Mean age of onset of symptoms was 52 years which included 3 young patients 10-30 year.
Reale, Deifini, Gambacona et al., 1978	37	Patients who have undergone surgery for congenital stenosis of the lumbar spinal canal.	Spondylolisthesis, root cyst, and iatrogenic stenosis of the canal were excluded because there were too few cases.	Part of a larger study comparing spinal stenosis patients to spondylosis patients and disk herniation patients.
Verbiest, 1977	116	Patients operated on for developmental lumbar spinal stenosis between 1948 and 1975 and in whom the mid-sagittal diameters of the whole area of stenosis was measured.	Patients with less than 1 year followup.	This study failed to give the mean age of patients, only the youngest and oldest. Other details on patient characteristics are also missing.The study is not clearly reported.
Case-series
Young, Veerapen, and O'Laoire, 1988	32	Lumbar canal stenosis	Not Stated
Kurihara, Tanaka, Tsumura et al., 1988	12	Hyperostotic lumbar spinal stenosis	Not Stated
Hall, Bartleson, Onofrio et al., 1985	68	Myelographic demonstration of total or subtotal obstruction to the passage of contrast medium in the lumbar spine	Previous lumbar surgery, tumor, abscess, predominant disk protrusion or extrusion as a cause of symptoms.
Weinstein, Scafuri, and McNeill, 1983	24	Only the spinal stenosis patients who had surgical decompression, had more than 1 year since surgical treatment, and were willing to return for reexamination by a second examiner.	Not reported.
Weir and De Leo, 1981	81	Clinical-radiological diagnosis of lumbar stenosis	None reported
Johnsson, Willner, and Pettersson, 1981	27	Patients who underwent laminectomies and extensive facetectomies	None reported
Verbiest, 1979	11	Not Stated	None reported	Patients had spondylolytic, isthmic and congenital spondylolisthesis. Most had spina bifida.
Salibi, 1976	20	Not Stated	Patients with herniated disks and no evidence of stenosis were excluded from analysis.	Six patients had disk herniation requiring disk removal as well as stenosis. 16 patients received wide bilateral laminectomy while 3 others received unilateral laminectomy. One patient refused surgery. No followup period is reported.
Trials Examining Surgical Patients with Lateral Lumbar Stenosis
Randomized controlled Trial
Lee and deBari, 1986	24	Diagnosis of multiple level foraminal stenosis	Not reported	Separate patient characteristics by treatment groups are not reported.
Controlled
Kirkaldy-Willis, Wedge, Yong-Hing et al., 1982	94	Patients who had 1 isolated lateral stenosis 2 lateral stenosis with disk herniation 3 lateral and central stenosis and 4 lateral and central stenosis with disk herniation. Only patients who did not respond to conservative therapy were operated on.	Spondylolisthesis or had undergone a previous spinal surgery.
Mikhael, Ciric, Tarkington et al., 1981	85	Patients with lateral recess stenosis.Asymptomatic patients are not described.	None reported	50 symptomatic patients are not described. Very little patient data on lateral recess stenosis patients are reported.The only patient described as poor was diabetic and had multiple prior laminectomies. Mean age and duration are presented for all patients.
Retrospective Trial with Consecutive Patients
Sanderson and Getty, 1996	66	Patients undergoing partial undercutting facetectomy for lumbar lateral recess stenosis between 1982 and 1988 at Northern General Hospital, Sheffield, England.	None reported.
Baba, Uchida, Maezawa et al., 1996	31	Patients who had undergone microsurgical nerve root canal widening for lumbosacral foraminal stenosis with a minimum of 1 year followup.	Patients presenting with symptomatic spondylolysis and isthmic or degenerative spondylolisthesis showing osteocartilaginous nerve root compression with the neural foramen were excluded.
Aryanpur and Ducker, 1990	32	Those patients with radiographic evidence of multilevel lateral canal stenosis that correlated with their symptoms and who lacked a significant central of pan-stenosis were considered appropriate candidates for multilevel decompressive laminotomies.	History of previous spinal surgery
Case-series
Choudhury and Taylor, 1977	28	Lateral lumbar stenosis. Diagnostic guidelines were given, but these were not inclusion criteria.	Overt Central stenosis.
Epstein, Epstein, Rosenthal et al., 1972	15	Sciatic pain with no surgical evidence of herniated disk.	Not Stated	Final diagnosis was made when exploratory surgery could find no disk herniations.
Trials Examining Surgical Patients with Centralor Lateral Lumbar Stenosis type of stenosis unspecified or includes both types of stenosis
Controlled Trial
Yone and Sakou, 1999	60	Lumbar spinal stenosis. Classification as stable/unstable by Posner scale.	Patients who had undergone multiple lumbar operations and those with spondylolysis or spondylolytic spondylolisthesis were excluded.	This study compares outcomes among patients with instability who got fusion with those who didn't. Also reports on patients without instability who just received decompression.
Epstein, 1999	21	Ossification of the Yellow Ligament or the Posterior Longitudinal Ligament with vertebral canal intrusion.	Not Stated	One patient in each group was excluded from analysis because of thoracic stenosis.Data for followup time includes these patients. Outcomes, Age and Sex data do no include these patients.
Javid and Hadar, 1998	170	All patients from January 1984 who underwent decompressive laminectomy for stenosis confirmed by CT and/or MRI.	Patients who had undergone previous surgery for stenosis were excluded.	3 patient groups: Central Stenosis, Central Stenosis and Herniated Disk, Lateral Stenosis. Dropouts were reported for the entire group at the long-term followup: 10 patients died of unrelated diseases, and 14 patients were lost to followup.
Kalbarczyk, Lukes, and Seiler, 1998	148	Over age 70	Patients undergoing simultaneous removal of a herniated disk were excluded.	Three different operations, depending on symptoms.Outcomes were reported separately.Patient characteristics are present for the entire group of patients. Average number of vertebral levels receiving surgery was 1.78.
Pai and Kumar, 1996	55	Claudication pain which caused significant functional disability, not relieved by conservative treatment, progressive neurological deficit, and cauda equina syndrome.	Not Stated	Sex distribution 44 Men and 9 Women and age ranges 20-68 were reported only for combined groups. First followup was by examine, later followup by questionnaire.Two patients were lost to followup at 1st followup, 7 more at 2nd followup.
Kawauchi, Yone, and Sakou, 1996	36	Patients with LSS whose symptoms had not been improved by conservative treatment	None reported	Patients were grouped according to degree of adhesive arachnoiditis of the cauda equina slight, moderate, marked.Patient diagnosis: degeneration LSS n=17 [10 with spondylolisthesis], combined type LSS n=15, and 4 with post-traumatic causes.
Cinotti, Postacchini, and Weinstein, 1994	50	Clinical symptoms of lumbar stenosis not improved by conservative treatment for more than 3 months with imaging evidence of a central or lateral stenosis.	Patients with diabetes type 1 or 2 were excluded if not requiring insulin or oral medication which started at least 3 years before the surgery.	Nondiabetic patients compared to diabetic patients.
Little and MacDonald, 1994	94	Patients who completed the Oswestry Low Back Pain Questionnaire both pre and post surgery.	Patients were excluded if a pre and post disability index was not recorded.	Part of a larger series of back surgery patients who had filled out the Oswestry Low Back Pain Questionnaire.Central and lateral stenosis patients were reported to have had decompressive laminectomy and fusion but the numbers in the tables do not match for diagnosis groups and surgery groups.Mean age is for the larger group.Very little information on patient characteristics is reported.
Simpson, Silveri, Balderston et al., 1993	57	Preoperative diagnosis of diabetes mellitus and spinal stenosis. All patients had failed to improved adequately after nonoperative management.	Workers' Compensation or involved in litigation.	This is a retrospective study comparing patients with diabetes and spinal stenosis with age and sex matched nondiabetic patients with spinal stenosis. Herniated disk patients were reported separately except for mean ages and range.
Jonsson and Stromqvist, 1993a	39	Patients had at least one previous lumbar spinal surgery and underwent a second operation for persistence or recurrence of back and leg pain.	None reported.	Trial was specifically designed to examine patients with recurrence of back and leg pain after at least one previous lumbar spinal operation. Patient characteristics are reported for a combined previous disk and stenosis surgery patients.
Nasca, 1989	114	Patients surgically treated for lumbar spinal stenosis.	Not Stated
Nather and Thomas, 1985	34	Must have signs of stenosis at surgery and have either clinical or radiological features of stenosis.	Not Stated	Several diagnoses and several treatments.Outcomes are reported separately by diagnosis. Complications and ability to work are reported for entire patient group. Only two diagnoses had sufficient number of patients to include in the database.
Paine, 1976	143	Not Stated	Not Stated	One patient died from complications of surgery, but the inclusion of this patientin one of the categories included in this analysis is not know.
Shenkin and Hash, 1976	49	Spinal stenosis patients incapacitated with intractable pain and had not responded to other therapeutic measures.	Patients with soft disk herniations in addition to spondylosis were excluded.	Patients were divided according to prior surgery or no prior surgery. The 21 patients with prior surgery had been operated on for herniated disks.
Tile, McNeil, Zarins et al., 1976	26	Spinal stenosis cases from St. Joseph Hospital in Toronto, Canada.	None reported.	Some surgical patients may have received fusion as well as standard wide laminectomy but results were reported as similar.No separate patients characteristics were reported for the stenosis surgery group.
Retrospective Trial with Consecutive Patients
Crock, Shiraishi, and Crock, 1995	34	Patients with congenital or advanced degenerative central and lateral lumbar stenosis in which 3 or more inter-laminal spaces were decompressed. Patients had a combined central and lateral stenosis and bilateral foraminal and nerve root canal decompressions.	Not reported	This is a special group of patients in which 3 or more inter-laminal spaces were decompressed.
Silvers, Lewis, and Asch, 1993	248	All patients received conservative therapy prior to surgery but had inconsistent responses. Lumbar myelography correlated with the clinical finding of neurogenic claudication and failure to respond to conservative therapy resulted in a recommendation for laminectomy.	None reported.	Long-term followup had 120 dropouts from 244 patients in the short-term followup. 26 patients were involved in worker's compensation claims.
Katz, Lipson, Larson et al., 1991	88	Patients 55 and over who had a laminectomy with or without fusion for degenerative lumbar stenosis at Brigham and Women's' Hospital between 1983 and 1986.	Patients with prior laminectomy or spinal arthrodesis of both were excluded.	22 patients had degenerative spondylolisthesis with at least 5 mm of forward slip.
Ganz, 1990	36	Patients who underwent surgery for lumbar spinal stenosis between January 1981 and December 1986. Selection criteria for surgery included a marked clinical disturbance and a myelogram showing the changes of spinal stenosis.	None reported	29 patients had standard wide laminectomy, 3 patients had hemilaminectomy with disk removal, and 1 had unilateral hemilaminectomy.The group is recorded in the database as standard wide laminectomy.
Case-series
Norcross-Nechay, Mathew, Simmons et al., 1999	70	Chronic at least 6 months lumbar stenosis.Multilevel lumbar decompression, instrumentation and fusion.	Stenosis from acute fractures, infectious processes or neoplastic disease.	This study is primarily concerned with somatosensory evoked potential recordings.
Guigui, Benoist, Delecourt et al., 1998	50	Consecutive patients operated on for lumbar spinal stenosis with severe motor deficit.	Not Stated	Various types of stenosis, treated with various types of surgery. Outcomes not separately reported.
Scholz, Firsching, and Lanksch, 1998	72	Neuroradiological and intraoperative findings suggested stenosis	Not Stated	Followup was provided by examination 2.5 years after surgery, and by mailed questionnaire at 8 years. 25 patients were lost to followup at 8 years.
Tsai, Yang, and Bray, 1998	62	Symptomatic degeneration. LS, include. Patients with mild deformity w/o gross instability degenerative scoliosis of <20deg., grade 1 spondylolisthesis w/o segmental instability, i.e., <4mm translation or <11deg. Angulation on flex./extension.	Prior back surgery, pure disk protrusion, cauda equina syndrome, congenital or developmental stenosis, Paget's disease, achondroplasia, total block on myelogram, <100mm^2 of canal area, scoliosis>20deg., grade 2 or + stenosis, segmental instability.	Data is provided only for the 50 patients not lost to followup.
Mackay and Wheelwright, 1998	50	All patients presented with symptoms and signs consistent with nerve root entrapment. CT, MRI or myelogram was obtained to confirm the diagnosis.	Not Stated
Whitecloud, Castro Jr, Brinker et al., 1998	35	Degenerative Conditions of the Lumbar Spine	Not Stated
Spetzger, Bertalanffy, Reinges et al., 1997	29	Patients with symptomatic lumbar spinal stenosis who were operated on by a unilateral and bilateral decompression.	Not Stated	Two patients received discectomy as well as decompressive laminotomy. All patients were examined at discharge and at 8-10 weeks. Final evaluation was by telephone at 6 to 26 months, mean 18 months.
Katz, Lipson, Chang et al., 1996	88	Clinical and radiographic evidence of degenerative lumbar spinal stenosis, underwent decompressive laminotomy with or without arthrodesis from 1983-1986, were older than 55 at time of surgery, had no prior surgery for lumbar spinal stenosis.	Not stated	No useful pretreatment data.
Lehto and Honkanen, 1995	96	Symptomatic Lumbar Spinal Stenosis.	Not Stated	Mixed diagnoses, mixed surgeries, all reported together.
Stucki, Liang, Fossel et al., 1995	230	Age>50years, pain in the low back, buttock and lower extremity exacerbated by lumbar extension, and evidence of central or central-lateral compression of the cauda equina by a degenerative lesion of the facet joint, disk, or ligamentum flavum.	Patients unable to complete questionnaires because of cognitive or language difficulties were excluded.
Tuite, Stern, Doran et al., 1994	380	Patients who underwent decompressive lumbar laminectomy in Washentaw county, MI between July 1983 and July, 1990.Must have a radiographically confirmed diagnosis of lumbar spinal stenosis.	Incomplete documentation, previous lumbar surgery, interlaminar decompression, total facetectomy, fusion, or instrumentation. Patients excluded for incomplete documentation would be more properly considered lost to followup.	An unknown and possibly large number of patients were excluded because they did not have sufficient pretreatment data.These patients should be marked lost to followup greater than 75%. Provides data as percentages which, due to rounding, do not account for all patients in each group. Patients which form a sub-group of 119 are presented in the database.
McCullen, Bernini, Bernstein et al., 1994	193	Patient received decompressive surgery for stenosis after cons. Treatment Failed, imaging shows compression consistent with symptoms.	Pending litigation, Pending workers' comp. Claims, infection, tumor previous spine surgery, dementia, stroke, requiring complete facetectomy.	Combined various etiologies and various surgeries.Some data on prognostic factors is reported.
Simmons and Simmons, 1992	40	Patients having a significant lumbar scoliosis associated with spinal stenosis with symptoms of neurogenic claudication and having been treated with posterior decompression and pedicular screw fixation.	None reported
Mauersberger and Nietgen, 1989	92	Lumbar stenosis	Not stated	Mixed diagnoses, mixed treatments, and sparse descriptions. 49% of patients did not receive conservative treatment prior to surgery.
Johnsson, Redlund-Johnell, Uden et al., 1989	61	Patients operated on for lumbar spinal stenosis.	Patients with an AP diameter of the dural sack of more than 11cm and patients with impaired circulation in the legs.
Brodsky, Hendricks, Khalil et al., 1989	36	Not Stated	Not Stated	Almost no information is provided.
Jalovaara, Lahde, Iikko et al., 1989	31	Myelographic demonstration of total or subtotal obstruction s to the passage of the contrast medium in the lumbar spinal canal.	Patients with spondylolytic spondylolisthesis, prior lumbar surgery, tumor, infection, and lumbar disk herniation	Two patients had prior intervention lumbar sympathectomy. Degree of stenosis was measured by myelography as the midsagittal diameter at the most constricted level. Number of surgical levels involved: single level n=11, 2 levels n=7, more than 2 levels n=13.
Fast, Robin, and Floman, 1985	19	Patients with spinal stenosis who were "found suitable for surgery".	Not Stated, but 41 patients apparently were found unsuitable for surgery.
Boccanera, Pellicioni, and Laus, 1984	25	Lumbar stenosis, including developmental, degenerative and mixed.	Spondylolisthesis
Hood and Weigl, 1983	21	Patients over age 50 with lumbar spinal stenosis requiring surgery.	Not Stated
Scafuri and Weinstein, 1981	27	Lumbar spinal stenosis	None reported.
Echeverria and Lockwood, 1979	35	Patients with lumbar stenosis operated on between 1966 and 1976.	Not Stated	Two patients categorized as having "miscellaneous" stenosis were excluded by us because 1 had stenosis due to giant-cell tumor. Another 5 were excluded because they may have had herniated disks. This is in addition to the 8 patients already lost to followup.
Scapinelli, 1978	23	Patients with lumbar spinal stenosis.	Patients found to have disk protrusions at operation.	Patient information is given for all 42 patients with stenosis. Only 23 had surgery.Etiology of stenosis varied, but treatment was the same.
Vestad and Naca, 1977	80	Spondylolisthesis	Not Stated	Includes multiple etiologies, some patients were fused while others were not.
McKinley and Davis, 1976	32	Narrow Lumbar Spinal Canal or Lumbar Spinal Stenosis.	Not Stated	Poor study with a large dropout rate 44%.Only 18 of 32 Patients followed up.No useful outcome measures were reported.
Teng and Papatheodorou, 1963	29	Lumbar spondylosis with Compression of Cauda Equina	Not Stated	One patient had discectomy and laminotomy.28 had laminectomy.
Epstein, Epstein, and Lavine, 1962	29	Symptoms of nerve root compression causally related to narrowing of the lumbar spinal canal.	Not Stated	Different patients received different surgery: Interlaminar laminotomy, Complete hemilaminectomy, Total laminectomy.
Epstein, 1960	14	Spondylosis of the lumbar spine.	Not Stated
Trials Examining Surgical Patients with Degenerative Spondylolisthesis
Randomized controlled Trial
Fischgrund, Mackay, Herkowitz et al., 1997	75	All patients had a clinical diagnosis of single-level degenerative spondylolisthesis and spinal stenosis.	Prior lumbar surgery.
Thomsen, Christensen, Eiskjaer et al., 1997	41	All patients had lumbar or lumbosacral instability, defined by severe, chronic motion-induced back pain	Age less than 20 or greater than 70. Metabolic bone disease osteoporosis, comorbidity, and psychosocial instability.	The 41 patients with degenerative spondylolisthesis were part of a larger study of spondylolisthesis in 130 patients.Patient characteristics were only available for the larger group. Patients were excluded if over 70 years of age.Data on fusion levels were presented for the entire larger patient group.
Bridwell, Sedgewick, O'Brien et al., 1993	43	Patients with primary surgery for spinal claudication caused by spinal stenosis at the level of the degenerative spondylolisthesis.	Prior surgery.	Patients with pathological motion were automatically randomized to fusion and instrumentation. Patient group 1, no fusion, has only 9 patients, but data was entered for completeness. Analysis can be performed between Group 2, fusion, and Group 3, fusion and instrumentation.
Herkowitz and Kurz, 1991	50	Clinical diagnosis of degenerative spondylolisthesis and spinal stenosis, symptoms unresponsive to an adequate trial of nonoperative treatment, single level of Spondylolisthesis, imaging studies consisting of plain x-ry and either myelogram, CT, or MRI.	None reported
Controlled Trials
Plotz and Benini, 1998	106	One or two vertebrae slipped forward at least 5% of their diameter.	Not Stated	Different numbers of patients age given for different outcomes. Patients who had 2nd surgery not included in analysis, except the global outcome, in which they were called "Worse". Most patient data given for combined groups only. Average slippage reported for all patients, 20%, range 12.5% to 44%.
Yuan, Garfin, Dickman et al., 1994	2684	Any patient with a diagnosis of degenerative spondylolisthesis, no prior fusion or instrumentation surgery at the same level, and posterior fixation and fusion surgery. Patient must have radicular pain and/or neurogenic claudication.	Prior fusion attempts at the operative site, involvement of more than 2 levels, surgery involving anterior fixation. Dysplastic, Isthmic, or Pathological etiology.	Data on exact followup times are not presented.This is a large cohort study with patient data provided by 314 surgeons. Data was provided by each surgeon on a standardized questionnaire.
Satomi, Hirabayashi, Toyama et al., 1992	41	Patients with degenerative spondylolisthesis who exhibited displacement greater than 5% by the Marique-Taillard method and were treated surgically.	None reported.	This study used the Japanese Orthopaedic Association JOA Questionnaire. Severity was based on Grades 1 no indention of dural sac, 2, and 3 complete block spondylolisthesis.
Lombardi, Wiltse, Reynolds et al., 1985	47	Degenerative Spondylolisthesis treated conservatively for an adequate period.	Previous surgery, involvement in litigation, significant lesions at other spinal levels, inadequate followup.	One group of 6 patients was too small to be included.
Prospective Trials
Nakai, Yoshizawa, and Kobayashi, 1999	23	Patients with spondylolisthesis who had undergone posterior lumbar intervertebral fusion.	None reported
Rechtine, Sutterlin, Wood et al., 1996	18	Patients with grade I or II degenerative spondylolisthesis treated with the ISF system and using 100% autogenous bone graft. Subluxation of one vertebra over another in the lateral radiographs, causing spinal stenosis or claudication and pain.Older than 17.	No slip noted on radiograph, a stable motion segment unit, and an asymptomatic condition.
Retrospective Trial with Consecutive Patients
Stambough, 1999	35	Cases of lumbosacral transpedicular screw fixation between 1986 and 1994. All cases had conservative and/or nonoperative care including bed rest, limited activities, physiotherapy, nonsteroidal AI, muscle relaxants, narcotics, epidural steroids and other treatments.	None reported	Part of a larger group of patients who received decompression, fusion, and instrumentation for variousback disorders. Mean age is from the larger study.
Nishizawa and Fujimura, 1997	58	Patients with degenerative spondylolisthesis who underwent anterior lumbar interbody fusion from 1982 through 1993 and who were followed a minimum of 2 years.	None reported	48 of 58 patients received screws as well as fusion.
Moller, Wittenberg, Nolte et al., 1992	37	Patients treated at the Department of Orthopedic Surgery, Ruhr University of Bochum for the treatment of degenerative lumbar spine diseases. Unsuccessful intensive conservative treatment for at least 1 year including local injections and physiotherapy and were trained in the back school.	Patients showing nerve root compression signs on EMG, evoked potentials, CT, or MRI were excluded.	Part of a larger study that included failed-back surgery and lumbar instability patients. Mean age is for the entire group of 147 patients.
Marchesi, Thalgott, and Aebi, 1991	30	Patients treated with AO spinal internal fixation system for nontraumatic indications at the author's institutions.	None reported	Part of a larger study. Not all spondylolisthesis patients are degenerative.
Takahashi, Kitahara, Yamagata et al., 1990	39	Patients with degenerative spondylolisthesis who underwent anterior interbody fusion.	None reported	CT was used in 22 patients.
Knox, Harvell, Nelson et al., 1989	39	Included all patients treated with bilateral laminectomy, fusion, and Luque rectangle for degenerative spondylolisthesis from 1983 to 1988. Nonsteroidal antiinflammatory medication, corsetry, and physical therapy did not generally provide relief.	None reported	Patient's levels of satisfaction have 3 "improved" levels and 1 level for "same or not improved".
Case-series
Booth, Bridwell, Eisenberg et al., 1999	49	Degenerative spondylolisthesis, No prior surgery, severe neurogenic claudication, treated similarly.	Not Stated	Reporting of back or leg pain not the pain scale was entered as Back Pain.
McCulloch, 1998	21	Patients had leg pain dominant over back pain, failed conservative care, were <80 years old, in reasonable health, had single or 2 level microsurgical laminotomy with single level uninstrumented intertransverse fusion using soft tissue envelope technique	Not Stated	Measured back and leg pain on analog scale, but did not report results.
Epstein, 1998b	28	"Unstable" Degen. Spondylo.: More than 4mm of translation and >10-12 degrees of angulation at the level of olisthy.	Not Stated	These patients had "Unstable" degenerative spondylolisthesis.
Mochida, Toh, Suzuki et al., 1997	10	Unstable lumbar spine	Patients with less than 2 years followup were excluded.	Patients with degenerative canal stenosis and herniated disks were also reported on, but did not have at least 10 patients/group. Another 4 patients were excluded for getting a different treatment.
Epstein, 1998a	290	Not Stated	Not Stated
Grob, Humke, and Dvorak, 1996	18	Anterior slippage of at least 25% in the olisthetic segment and advanced stage of disk resorption with reduction of disk height by at least 75%.	Not described
Herron and Trippi, 1989	24	Patients with L4-5 Degenerative Spondylolisthesis with slip of at least 4mm or 10%, Followup at least 18 months.	Death before 1-year followup, Compensation or litigation issues, prior surgery at L4-5 level.
Chang and McAfee, 1989	17	Patients with degenerative spondylolisthesis or scoliosis with at least 1 year of followup. None had previous lumbar surgery, but it is not clear if this was a requirement.	Not Stated	Three of the patients had degenerative scoliosis, not spondylolisthesis and were not reported separately. Some patients may have been rejected because the followup was not long enough.
Inoue, Watanabe, Goto et al., 1988	36	Degenerative spondylolisthesis	Not stated	Patients were given fusion, but no mention is made of decompression.
Simmons and Capicotto, 1988	15	A select high-risk group of patients with a primary diagnosis of degenerative spondylolisthesis.	Not Stated	No useful treatment outcomes were measured.
Hanley, 1986	20	Localized L4-5 degenerative spondylolisthesis treated with the same technique, having at least 2 years of followup.	Evidence of disk herniation.	An additional 19 patients were treated the same way for the same condition. These patients may have been lost to followup or they may have had less than the required 2 years of followup at the time of publication.
Kaneda and Kazama, 1986	54	Degenerative unstable spondylolisthesis	Not Stated
Alexander Jr, Kelly Jr, Davis Jr et al., 1985	50	Intact Arch Spondylolisthesis	Not Stated	Outcomes are not reported for 5 patients because they were operated on within 4 months of publication.
Dall and Rowe, 1985	26	Treated for degenerative Spondylolisthesis at Bronson and Borgess hospitals.	Not Stated
Epstein, Epstein, Carras et al., 1983	60	Degenerative spondylolisthesis patients were selected after having shown no response to prolonged conservative care.	None reported.	Multiple decompression techniques were used over a 12 year period. Patients had no response to prolonged conservative care. Followup for 40 patients was 1-12 mo, and for 20 patients 13 mo to 7.5 years.
Richardson and Brown, 1980	21	Patients who underwent decompression and fusion for spondylolisthesis between 1976 and 1979.	Nor reported	Poorly reported study. Does not provide patient ages except to say they were adults.
Cauchoix, Benoist, and Chassaing, 1976	26	Degenerative Spondylolisthesis	Not Stated
Epstein, Epstein, Lavine et al., 1976	20	Not Stated	Not Stated	Study did not provide outcomes of surgical treatment.
Trials Examining Surgical Patients with Lumbar Stenosis and/or Degenerative Spondylolisthesis
Controlled Trial
Rompe, Eysel, Zollner et al., 1999	117	Age greater than or equal to 45; presence of back, buttock and/or leg pain; radiographic evidence of degenerative spinal stenosis; surgeon's opinion that the patient suffered from clinically significant degenerative lumbar spinal stenosis.	Previous lumbar spine surgery.	Patients were asked about pain and did not distinguish between back and leg separately. Pain scores are reported in the back pain outcomes table.
Katz, Lipson, Lew et al., 1997	272	Age >49 and the presence of one of the following: 1 back, buttock and/or lower extremity pain; 2 radiographic evidence of compression of the cauda equina or exiting nerve roots by ligamentum flavum, facet joints, osteophytes, and/or disk material; and 3 the surgeon's judgment that patients had significant degenerative lumbar spinal stenosis.	Patients with previous back surgery for stenosis.Patients who could not answer questionnaires because of language or cognitive limitations were excluded.	Dropouts are reported for the entire study patient population and not for the three treatment groups. 310 consecutive patients were initially eligible, 38 refused and 272 entered the study. At 6 months 2 patients had died and 34 refused to continue; 236 patients completed 6 months. At 24 months 8 patients had died and 29 refused to continue; 199 patients continued. Within the treatment groups, the patients receiving fusion had significantly fewer levels decompressed and greater frequency of spondylolisthesis.
Sato and Kikuchi, 1997	81	Consecutive patients with neurogenic intermittent claudication NIC induced by spinal canal stenosis due to spondylosis and degenerative spondylolisthesis of the L4 vertebra.	Not reported	Patient grouping based on number of levels involved; Group 1= 2-levels; Group 2 = 1-level; Preoperative patient were stratified by type of claudication: radicular n=7, Gp1; n=25, Gp2, caudal n=5, Gp1; n=9, Gp2, and mixed n=16, Gp1, n=19, Gp2
Rompe, Eysel, Hopf et al., 1995	60	Degenerative stenosis of the central lumbar spinal canal.	Patients with previous lumbar surgery, vascular disease of the legs, or compensation issues.	Two diagnoses and 2 types of surgery.Patients were reported separately, grouped by diagnosis. Patients in either group may have received either treatment. Some outcomes were reported separately for the 2 surgeries.
Sanderson and Wood, 1993	34	Patients aged 65 and over who received decompressive surgery for degenerative spinal stenosis at Wrightington Hospital between 1984 and 1989.	None reported	Reported central, lateral, and spondylolisthesis patients. Central and lateral patients were combined due to small sample size.
Robertson, Grobler, Novotny et al., 1993	33	Undergoing spinal decompression without fusion for symptomatic spinal stenosis at L4-5.	None reported.
Postacchini, Cinotti, Perugia et al., 1993	70	Patients with central lumbar stenosis requiring surgery.	None reported	Patients had one of four types of stenosis: developmental, degenerative, combined developmental and degenerative, degenerative spondylolisthesis. Patients were shifted from multiple laminotomy to total laminectomy for a would not allow adequate neural decompression, b risk of neural damage because of severe narrowing of the spinal canal, and c an inadequate bony bridge remained between laminotomies risking mobility of the residual laminae and spinous process.
Hirabayashi, Kumano, and Kuroki, 1991	53	Patients who underwent surgery using the Cotrel-Dubousset pedicle screw system at Kantoh Rosai Hospital between August 1986 and November 1989.	None reported	Part of a larger study. Mean age and range are based on the larger study.
Herkowitz and Garfin, 1989	99	Patients who had decompression for symptomatic and myelographically confirmed spinal stenosis.	Not Stated	Most of the patient information is for all groups, including those with scoliosis.
Prospective Trial
Jonsson, Annertz, Sjoberg et al., 1997a	105	Consecutive patients for surgical decompression for central lumbar spinal stenosis	None	Study reported mean anterior-posterior diameter of dural sac v. walking, v. stenosis/stenosis + spondylolisthesis. Study reported the number of levels with anterior-posterior diameter < or =10 mm.
Postacchini and Conotti, 1992	88	Surgery for lumbar spinal stenosis at the Orthopaedic Clinic of La Sapienza University of Rome between 1972 and 1985.	None reported.	Development, degenerative, and combined stenosis patients were evaluated. 48 patients out of 88 were not available for followup. 16 patients had spondylolisthesis. Total laminectomy 32 patients and bilateral laminotomy 8 patients were combined. 10 patients were fused. 21 patients were not examined because they did not have an immediate postoperative radiograph.
Retrospective Trial with Consecutive Patients
Chen, Baba, Kamitani et al., 1994	80	Patients with lumbar spinal stenosis who underwent decompressive surgery at the Department of Orthopaedic Surgery, Fukui Medical School between 1983 and 1990.	Patients with diseases such as diffuse idiopathic skeletal hyperostosis.	Several forms of stenosis and several surgical treatments. 15 degenerative stenosis, 13 combined degenerative and developmental stenosis, 14 degenerative spondylolisthesis, and 6 isthmic spondylolisthesis. 13 total laminectomy, 35 partial laminectomy.
Postacchini, Cinotti, Gumina et al., 1993	64	Patients who received surgery for lumbar spinal stenosis between 1972 and 1988 at the Orthopedic Clinic of the University of Modena and the Orthopedic Clinic of the University of Rome.Patients were followed at least 6 months.	None reported.	Development, degenerative, and combined stenosis patients were evaluated. 25 patients had spondylolisthesis. Total laminectomy 28 patients and bilateral laminotomy 19 patients were combined.17 patients were fused.Study did not report patient ages.
Case-series
Guigui, Barre, Benoist et al., 1999	28	Patients with lumbar spinal stenosis who underwent decompressive surgery between November 1984 and January 1988 in the authors' department Orthopaedic Department, Hospital Beaujon, Clichy, France.	None reported.	Outcomes are not reported per type of spinal stenosis or type of surgery. 17 patients had degenerative lumbar stenosis without spondylolisthesis and 6 patients had degenerative lumbar stenosis with spondylolisthesis.2 patients had fusion.Randomly selected 28 patients from a pool of 76 patients.
Trials Examining Surgical Patients and Patients Receiving Conservative Treatment
Patients with Central Lumbar Stenosis
Simotas, Dorey, Hansraj et al., 2000	55	Only patients over 50 years of age were included.Diagnosis of lumbar spinal stenosis based on radiographic and clinical findings. All patients had disabling back, buttock, or leg pain with at least one level of central lumbar spinal stenosis.	Patients with previous back surgery.	This is a cohort study of originally nonoperated patients. 6 patients dropped out one died during the study, 9 needed surgery, and 40 remained on conservative therapy.
Mariconda, Zanforlino, Celestino et al., 2000	37	Radicular pain with or without low back pain, stenosis classified as degenerative or combined, age more than 40 years, and narrowing of the central portion of the spinal canal with the area of the dural sac less than 130 mm2 at one or more intervertebral levels.	Congenital or constitutional stenosis, pure lateral stenosis, previous back surgery, and age less than 40 years.	The patient characteristics are reported for the entire group before dividing into operated and nonoperated patients.Each of the outcomes is part of the scoring system for the Beaujon Scoring System.
Johnsson, Uden, and Rosen, 1991	76	Patients who from 1974 to 1985 were treated surgically because of spinal stenosis and patients not so treated because the anesthesiologist refused to administer anesthesia because of advance cardiovascular disease 2 patients or the patients refused surgery 18 patients.	The only untreated patient with severe stenosis was not reported in order to obtain comparable patient groups untreated with moderate stenosis, surgery with moderate stenosis, surgery with severe stenosis. Patients who had undergone previous spinal surgery, had impaired circulation in the legs, or had a minimal midsagittal diameter of the dural sac of greater than or equal to 12 mm.	Whether the study was performed prospectively or retrospectively is unclear. Walking capacity in meters was subjectively assessed at diagnosis and at followup suggesting that the study was prospectively conducted.None of the untreated patients were lost to followup, but 7 of the surgical patients died, and 5 patients did not participate. The dropouts from the surgical group were not distinguished as moderate or severe stenosis.
Patients with Central or Lateral Lumbar Stenosis Unspecified
Amundsen, Weber, Nordal et al., 2000	100	Participants had sciatic pain in the leg s, with or without pain in the back, together with radiologic signs of stensosis and compression of the clinically afflicted nerve root s	Patients were excluded if they had a bulging or herniated disk, spondylolysis, coxarthosis, gonarthosis, arterial insufficiency in the legs, polyneuropathy, concomitant serious disease, or previous surgery on the back	Study randomized patients with moderate symptoms to either conservative or surgical treatment. Patients with severe symptoms were given surgery and patients with mild symptoms were given conservative treatmen
Hurri, Slatis, Soini et al., 1998	134	Functional myelography diagnostic of spinal stenosis between 1978 and 1982 and interviewed by telephone in 1993.Based on the narrowest sagittal diameter on functional myelography, the diameter must be 10.5 mm or less.	Those with narrow dural sac without indentations were excluded, because they were considered to represent a constitutional form of narrow dural sac.	Of the original 134 patients, 48 died during the 12 year followup period, and 9 could not be traced.
Atlas, Deyo, Keller et al., 1996	148	Diagnosis of lumbar spinal stenosis based on appropriate symptoms and radiographic findings consistent with spinal stenosis, including patients with spina stenosis associated with a herniated lumbar disk.	Exclusion criteria included prior lumbar spine surgery, cauda equina syndrome, developmental spinal deformities, vertebral fractures, spine infection or tumor, inflammatory spondylopathy, pregnancy, or age younger than 18 years.	Practices of orthopedic surgeons and neurosurgeons from Maine were recruited to provide patient information.No estimate of potential patients who did not enter the study. 71 of 81 surgery patients received laminectomy; the other 10 had open discectomy only 7 or laminectomy and fusion 3. 60% of surgical patients and 68% of nonsurgical patients had comorbid illnesses, but specific incidences were not reported. Patients with spinal stenosis due to herniated disk were included.
Atlas, Keller, Robson et al., 2000	119	Four year followup to Atlas, Deyo, Keller et al., 1996
Swezey, 1996	47	Sequential patients diagnosed in 1986-1987 who met the clinical criteria of neurogenic claudication secondary to lumbar spinal stenosis and were available for telephone interview or reexamination in 1993.	4 of 51 patients had mild stenosis by CT or MRI and were excluded.	Patient characteristics are only available for the entire patient group and are not listed by treatment. A surgical group 11 patients and a nonsurgical group 36 patients were examined. Within the nonsurgical group are patients given pelvic traction.
Nagler and Bodack, 1993	100	All patients diagnosed as having lumbar spinal stenosis who attended the Department of Rehabilitation Medicine at the New York Hospital - Cornell University Medical Center form January 1, 1980 to December 31, 1983. Inclusion in the study required clinical symptoms at the time of initial evaluation of pain, numbness, and weakness in the lower back and extremities which was typically worse with standing or walking and which was relieved by sitting or lying, and a positive CT scan and/or myelogram. Surgical patients were a selected group with fewer concomitant medical problems.	Patient were excluded if they had a predominant extrusion or protrusion of a disk as the cause of their symptoms.	Of an original 100 patients only 80 could be contacted for followup information. No individual patient signs and symptoms were reported. The anterior-posterior diameter of the lumbar spinal canal was measured and the mean reported according to improvement aftertreatment not by treatment groups: Excellent n=12, 10.00 mm; Good n=13, 10.08 mm; Fair n=6, 10.48 mm; Slight n=4, 10.32 mm; Same n=7, 10.00 mm.
Herno, Airaksinen, Saari et al., 1996	57	Nonoperative lumbar spinal stenosis patients who had undergone myelography were identified.	Prior back surgery.	The conservatively treated patients were selected as patched pairs to surgical patients. The surgical patients were part of a larger group of patients undergoing surgery that are reported elsewhere in this database.
Patients with Degenerative Spondylolisthesis
Fitzgerald and Newman, 1976	43	Patients referred initially to a special back clinic with symptomatic degenerative spondylolisthesis.	None reported	This is a retrospective trial in which the control conservatively treated group has a less severe condition than the surgical group.
Rosenberg, 1976	200	Patients with degenerative spondylolisthesis examined between 1956 and 1968.	Patients with less than 5% slipping were excluded.	Retrospective study of nonsurgical and surgical patients with little actual patient information or outcome measurements.Of 200 patients, 159 were female, mean age 61 years, range 44 to 89.
Trials Describing Only the Natural History of Lumbar Spinal Stenosis Patients
Patients with Central Lumbar Stenosis
Hamdan and Al-Kaissie, 1994	75	50 patients were selected at random method not defined from 1500 cases attending the orthopedic clinic in Basrah University Hospital. All had back ache and/or sciatica. 25 patients with lumbar canal stenosis were included for comparison and seem to have come from the 50 randomly selected patients. 50 normal patients were selected from patients attending the radiological departments with complaints other than back problems.	Not reported.	Surgical outcome data were not extracted because only 17 of 25 patients received surgery and the patient conditions/characteristics were not defined. Several different surgical approaches were used. 50 normal patients were used for spinal measurements only and no patient characteristics data are available. Only range data is provided for the canal ratio measurement and this only for the normal group.
Patients with Lateral Lumbar Stenosis
Jonsson and Stromqvist, 1993b	100	First 100 patients from 1986 admitted for decompressive surgery of the lumbar spine and had lateral stenosis.	None reported.	Only the lateral stenosis patients were extracted.The central stenosis patients were probably part of an update published in 1997 Jonsson, Annertz, Sjoberg et al., 1997a; Jonsson, Annertz, Sjoberg et al., 1997b that also described patient characteristics prior to surgery for central stenosis patients only from 1986 to 1991.
Patients with Degenerative Spondylolisthesis
Matsunaga, Sakou, Morizono et al., 1990	40	Patients with degenerative spondylolisthesis and slippage of 5% or more for the past 15 years without surgery or long-term conservative therapy.	None reported	40 patients were followed who did not have surgery or long-term conservative therapy. 3 patients were trauma cases.
Sato, Wakamatsu, Yoshizumi et al., 1989	355	Patients with a forward slip of L4 onto L5 of more than 3 mm on lateral radiographs.	Patients with transitional vertebrae were excluded.	Little information is available on the control group of patients who had low-back pain but no spondylolisthesis.
Patients with Lumbar Stenosis and Spondylolisthesis
Radu and Menkes, 1998	62	Patients admitted to the Cochin Teaching Hospital Rheumatology Unit between July 1995 and June 1996 for lumbar spinal stenosis.	A 12 year old with congenital lumbar spinal stenosis was excluded.	Comorbidity was high. Duration was given per years, 21% less than 1 year, 21% greater than 5 years. Of 62 patients only 8 went on to surgery.
Amundsen, Weber, Lilleas et al., 1995	100	Sciatic pain with or without pain in the back.Radiologic signs of compression on the clinically afflicted nerve root s.	Excluded if nerve root compression was primarily caused by a bulging or herniated disk, tumor, or infection. Previous back surgery, Spondylolysis or lytic spondylolisthesis, arterial insufficiency, polyneuropathy, concomitant serious disease.	Pretreatment data only. Distribution of conditions: 51 lateral and 49 central stenosis; 72 degenerative, 13 developmental, and 15 combined. 12 patients had degenerative spondylolisthesis.No correlation between degree of stenosis and degree of pain Chi-square P value of 0.6
Johnsson, Uden, and Rosen, 1992	32	Patients with spinal stenosis who were observed only i.e.., no surgery during the study period.	Prior spinal surgery; impaired circulation in the legs; canal AP diameter >11 mm	Observational study of a "no treatment" group of spinal stenosis patients; Reported pre- post symptoms for all patients followed and also stratified by anterior-posterior canal diameter, pain level and walking distance by outcomes.

Evidence Table 9. Patient Treatment Information for Clinical Trials of Patients with Lumbar Spinal Stenosis

Randomized controlled Trials of Patients Receiving Conservative Treatments
First Author and Year of Publication	Patient Group	N	Treatment	Description of Treatment
Trials Examining Surgical Patients with Central or Lateral Lumbar Stenosis type of stenosis unspecified or includes both types of stenosis
Fukusaki, Kobayashi, Hara et al., 1998	1	16	Epidural Saline	Three epidural injections of 8ml saline over 1 week as a control treatment.
	2	18	Epidural Anesthetics	Three epidural injections of 8ml of 1% mepivacaine over 1 week.
	3	19	Epidural Anesthetics and Steroids	Three epidural injections of 1% mepivacaine and 40mg methylprednisolone over 1 week.
Eskola, Pohjolainen, Alaranta et al., 1992	1	20	Calcitonin Injections	Patients were injected with 100 IU of calcitonin every 2 days for 4 weeks. After a 2-month washout, patients were injected with placebo on the same schedule.Blind, cross over design.
Eskola, Pohjolainen, Alaranta et al., 1992	2	19	Calcitonin Injections	Patients were injected with placebo every 2 days for 4 weeks. After a 2-month washout, patients were injected with 100 IU of calcitonin on the same schedule. Blind, cross over design.
Cuckler, 1985 Cuckler, Bernini, Wiesel et al., 1985	1	20	Epidural Anesthetics and Steroids	7 ml of fluid was injected into the epidural space between the third and fourth lumbar vertebrae containing 2 ml with 80 mg of methylprednisolone acetate and 5 ml of 1% procaine.
Cuckler, 1985 Cuckler, Bernini, Wiesel et al., 1985	2	17	Epidural Anesthetics	7 ml of fluid was injected into the epidural space between the third and fourth lumbar vertebrae containing 2 ml of sterile water and 5 ml of 1% procaine.
Patients with Degenerative Spondylolisthesis
Sinaki, Lutness, Ilstrup et al., 1989	1	29	Exercise/flexion	Flexion exercises- Abdominal Strengthening, Pelvic Tilt, Chest-to-thigh position.
Sinaki, Lutness, Ilstrup et al., 1989	2	19	Exercise/extension	Extension exercises- Upper back extension from prone position, Hip extension from prone position.

Trials Examining Surgical Patients with CentralLumbar Stenosis
First Author and Year of Publication	Patient Group	N	Treatment and Specific or Unique Condition	Type of Fusion	Type of Instrumentation	Concurrent Therapy
Randomized controlled Trial
Grob, Humke, and Dvorak, 1995	1	15	Partial laminectomy or hemilaminectomy	None	None	If necessary herniated disk were removed.
	2	15	Partial laminectomy with fusion and instrumentation for single level	Arthrodesis of the most stenotic segment, autologous bone graft from the iliac crest	Fixed with a translaminar screw	If necessary herniated disk were removed.
	3	15	Partial laminectomy with fusion and instrumentation for multiple levels	Arthrodesis of multiple segments, autologous bone graft from the iliac crest	Cotrel-Dubousset instrumentation with screws in 8 patients, the AO system in 7 patients.	If necessary herniated disk were removed.
Controlled Trials
Herno, Saari, Suomalainen et al., 1999	1	35	Mixed Decompression Techniques - no post-surgery stenosis	None	None	None
Herno, Saari, Suomalainen et al., 1999	2	57	Mixed Decompression Techniques - post-surgery stenosis	None	None	None
Herno, Partanen, Talaslahti et al., 1999	1	41	Standard Wide Decompressive Laminectomy post surgery stenosis	None	None	None
Herno, Partanen, Talaslahti et al., 1999	2		Standard Wide Decompressive Laminectomy no post surgery stenosis	None	None	None
Hanakita, Suwa, and MIzuno, 1999	1	59	Standard Wide Decompressive Laminectomy SWDL	None	None	None
	2	61	Standard Wide Decompressive Laminectomy	None	None	None
	3	16	Partial laminectomy or hemilaminectomy	None	None	None
	4	20	SWDL with Fusion Arthrodesis	None	None	None
Thomas, Rea, Pikul et al., 1997	1	12	Standard Wide Decompressive Laminectomy	None	None	None
Thomas, Rea, Pikul et al., 1997	2	14	Laminotomy	None	None	None
Yone, Sakou, Kawauchi et al., 1996	1	10	SWDL with Fusion and Instrumentation	Posterior-lateral fusion	Steffee plate and Diapason in 5 patients, Knodt distraction rod in 5 patients	None
Yone, Sakou, Kawauchi et al., 1996	2	17	Laminotomy	None	None	None
Ray, 1982	1	48	Standard Wide Decompressive Laminectomy	None	None	None
Ray, 1982	2	17	Partial laminectomy or hemilaminectomy	None	None	None
Surin, Hedelin, and Smith, 1982	1	15	Standard Wide Decompressive Laminectomy - marked stenosis	None	None	None
Surin, Hedelin, and Smith, 1982	2	7	Standard Wide Decompressive Laminectomy - moderate stenosis	None	None	None
Tajima, Fukazawa, and Ishio, 1980	1	13	Mixed Decompression Techniques	11 patients given wide laminectomy, 2 patients given laminectomy and fusion	None	None reported
	2	14	Mixed Decompression Techniques - disk lesion	6 patients with laminectomy only, 5 patients with laminectomy and fusion, 3 patients with Love's method	None	All patients had a herniated disk.No other therapies were reported.
Prospective Trials
Weiner, Walker, Brower et al., 1999	1	54	Partial Laminectomy	None	None	None
diPierro, Helm, Shaffrey et al., 1996	1	30	Partial Laminectomy	None	None	None
diPierro, Helm, Shaffrey et al., 1996	1	35	Hemilaminectomy and fusion	Contralateral fusion using bone chips from the hemilaminectomy	None	In-house physical therapy and outpatient physical therapy.
Retrospective Trial with Consecutive Patients
Vitaz, Raque, Shields et al., 1999	1	65	Mixed Decompression Techniques	Posterior spinal fusion	Pedicle screw fixation	None
Matsui, Kanamori, Ishihara et al., 1997	1	27	SWDL with Fusion Arthrodesis	Bone graft harvested from the spinous process are placed on the open gap and tied with a steel wire. Bone graft and chips from the posterior ilium are placed on the laminae and facet joint surfaces.	None	Body cast for 1 month and soft brace for 2-3 months.
Airaksinen, Herno, Turunen et al., 1997	1	497	Standard Wide Decompressive Laminectomy	None	None	None
Mullin, Rea, Irsik et al., 1996	1	72	Standard Wide Decompressive Laminectomy	None	None	None
Ishac, Alhayek, Fournier et al., 1996	1	34	Standard Wide Decompressive Laminectomy	None	None	None
Jonsson and Stromqvist, 1994	1	43	Partial laminectomy or hemilaminectomy	None	None	None
Caputy and Luessenhop, 1992	1	100	Standard Wide Decompressive Laminectomy	None	None	None
Dhar and Porter, 1992	1	36	Standard Wide Decompressive Laminectomy	None	None	None
Chahal, Mundkur, Sancheti et al., 1982	1	32	Standard Wide Decompressive Laminectomy	None	None	None
Rosomoff, 1981	1	50	Standard Wide Decompressive Laminectomy	None	None	None
Getty, 1980	1	35	Standard Wide Decompressive Laminectomy	None	None	None
Reale, Deifini, Gambacona et al., 1978	1	37	Standard Wide Decompressive Laminectomy - congenital stenosis	None	None	None
Verbiest, 1977	1	116	Standard Wide Decompressive Laminectomy - congenital stenosis	None	None	None
Case-series
Young, Veerapen, and O'Laoire, 1988	1	32	Decompressive Surgery	None	None	None
Kurihara, Tanaka, Tsumura et al., 1988	1	12	Standard Wide Decompressive Laminectomy - hyperostotic stenosis	None	None	None
Hall, Bartleson, Onofrio et al., 1985	1	68	Standard Wide Decompressive Laminectomy	None	None	None
Weinstein, Scafuri, and McNeill, 1983	1	24	Standard Wide Decompressive Laminectomy	1 patient required supplemental posterolateral fusion	None	None
Weir and De Leo, 1981	1	81	Standard Wide Decompressive Laminectomy	None	None	None
Johnsson, Willner, and Pettersson, 1981	1	27	Standard Wide Decompressive Laminectomy	None	None	None
Verbiest, 1979	1	11	SWDL with Fusion Arthrodesis - congenital lumbar stenosis	Anterior console lumbosacral fusion	None	None
Salibi, 1976	1	19	Standard wide laminectomy 16 patients and unilateral laminectomy 3 patients	None	None	None
Trials Examining Surgical Patients with Lateral Lumbar Stenosis
Randomized controlled Trials
Lee and deBari, 1986	1	12	SWDL with Fusion Arthrodesis	Bilateral-lateral fusion from L3 to the sacrum	None	Progressive ambulation training and physical therapy.Some patients were allowed to wear elastic lumbosacral corsets postoperatively, but no rigid braces were allowed.
Lee and deBari, 1986	2	12	SWDL with Fusion and Instrumentation	Bilateral-lateral fusion from L3 to the sacrum	Knodt distraction rods	Progressive ambulation training and physical therapy.Some patients were allowed to wear elastic lumbosacral corsets postoperatively, but no rigid braces were allowed.
Controlled Trials
Kirkaldy-Willis, Wedge, Yong-Hing et al., 1982	1	20	Partial laminectomy or hemilaminectomy	None	None	None
	2	32	Partial laminectomy or hemilaminectomy - with disk herniation	None	None	None
	3	21	Partial laminectomy or hemilaminectomy - Lateral and Central Stenosis	None	None	None
	4	21	Partial laminectomy or hemilaminectomy - Lateral and Central Stenosis and disk herniation	None	None	None
Mikhael, Ciric, Tarkington et al., 1981	1	35	Standard Wide Decompressive Laminectomy	None	None	None
Mikhael, Ciric, Tarkington et al., 1981	2	50	Control/Placebo/None	None	None	None
Retrospective Trial with Consecutive Patients
Sanderson and Getty, 1996	1	66	Laminotomy	None	None	None
Baba, Uchida, Maezawa et al., 1996	1	31	Laminotomy	None	None	None
Aryanpur and Ducker, 1990	1	32	Laminotomy	None	None	None
Case-series
Choudhury and Taylor, 1977	1	28	Standard Wide Decompressive Laminectomy	None	None	If a disk prolapse was found it was removed.
Epstein, Epstein, Rosenthal et al., 1972	1	15	Foraminotomy/nerve root decompression	None	None	None
Trials Examining Surgical Patients with Central or Lateral Lumbar Stenosis type of stenosis unspecified or includes bothtypes of stenosis
Controlled Trial
Yone and Sakou, 1999	1	14	Laminotomy - patients with instability	None	None	None
	2	19	Laminotomy with Fusion and Instrumentation - patients with instability	Posterolateral spinal fusion	16 Diapason pedicle screw system, and 3 Knodt distraction rod.	None
	3	27	Laminotomy - patients without instability	None	None	None
Epstein, 1999	1	10	Standard Wide Decompressive Laminectomy - patients with Ossification of the Posterior Longitudinal Ligament	None	None	None
Epstein, 1999	2	11	Standard Wide Decompressive Laminectomy - patients with Ossification of the Yellow Ligament	None	None	None
Javid and Hadar, 1998	1	86	Standard Wide Decompressive Laminectomy - patients with central stenosis	9 patients received fusion.	None	None
	2	61	Standard Wide Decompressive Laminectomy - patients with central stenosis and herniated disks	None	None	None
	3	23	Standard Wide Decompressive Laminectomy - patients with lateral stenosis	None	None	None
Kalbarczyk, Lukes, and Seiler, 1998	1	93	Standard Wide Decompressive Laminectomy - patients without instability	None	None	None
	2	46	Partial laminectomy or hemilaminectomy - patients with mild instability	None	None	Note: Patients in this group had low grade Meyerding grade 0 or 1 spondylolisthesis; no fusion was done.
	3	9	Partial laminectomy and fusion - patients with high instability	Not described	None	Note: Patients in this group had high grade Meyerding grade 2 or higher spondylolisthesis. Fusion was done.
Pai and Kumar, 1996	1	30	Decompressive Surgery - patients with congenital stenosis	None	None	None
Pai and Kumar, 1996	2	23	Decompressive Surgery - patients with degenerative stenosis	None	None	None
Kawauchi, Yone, and Sakou, 1996	1	7	Partial laminectomy and fusion - patients with slight adhesions	None	None	None
	2	16	Partial laminectomy and fusion- patients with moderate adhesions	None	None	None
	3	13	Partial laminectomy and fusion- patients with marked adhesions	None	None	None
Cinotti, Postacchini, and Weinstein, 1994	1	25	Standard Wide Decompressive Laminectomy - patients with diabetes	None	None	None
Cinotti, Postacchini, and Weinstein, 1994	2	25	Standard Wide Decompressive Laminectomy - patients without diabetes	None	None	None
Little and MacDonald, 1994	1	60	SWDL with Fusion Arthrodesis	Not described	None	None
Little and MacDonald, 1994	2	34	SWDL with Fusion Arthrodesis	Not described	None	None
Jonsson and Stromqvist, 1993a	1	20	Partial laminectomy or hemilaminectomy - patients with central stenosis	None	None	None
Jonsson and Stromqvist, 1993a	2	19	Partial laminectomy or hemilaminectomy - patients with lateral stenosis	None	None	None
Simpson, Silveri, Balderston et al., 1993	1	33	Standard Wide Decompressive Laminectomy - patients with diabetes	None	None	These are diabetic patients treated with insulin or oral anti-diabetic medications.
Simpson, Silveri, Balderston et al., 1993	2	24	Standard Wide Decompressive Laminectomy - patients without diabetes	None	None	None
Nasca, 1989	1	15	Decompressive Surgery - patients with lateral lumbar stenosis	2 patients required posterior-lateral fusion 1 and 3 years later.	None	None
	2	29	Decompressive Surgery - patients with central or combined lumbar stenosis	None	None	None
	3	16	Decompressive Surgery with fusion and instrumentation - patients with central or combined lumbar stenosis	Posterior-lateral fusion	7 had Knodt rods, the rest had no instrumentation
	4	21	Decompressive Surgery - patients with postsurgical stenosis	None	None	None
	5	22	Decompressive Surgery with fusion and instrumentation - patients with instability	Posterior-lateral	16 had instrumentation. Type not stated.
	6	11	Decompressive Surgery with fusion and instrumentation - patients with degenerative stenosis and scoliosis		Harrington-Moe rods. 2 patients had no instrumentation.
Nather and Thomas, 1985	1	11	Decompressive surgery with or without fusion - patients with degenerative lumbar stenosis
Nather and Thomas, 1985	2	14	Decompressive surgery with or without fusion - patients with combined degenerative and congenital lumbar stenosis
Paine, 1976	1	95	Standard Wide Decompressive Laminectomy - patients with degenerative stenosis
Paine, 1976	2	48	Standard Wide Decompressive Laminectomy- patients with degenerative stenosis and disk herniation
Shenkin and Hash, 1976	1	49	Standard Wide Decompressive Laminectomy - patients with no prior surgery	None	None	None
Shenkin and Hash, 1976	2	21	Standard Wide Decompressive Laminectomy - patients with prior surgery for herniated disk	None	None	None
Tile, McNeil, Zarins et al., 1976	1	26	Mixed Decompression Techniques - patients with lumbar stenosis	2 patients were fused.
Tile, McNeil, Zarins et al., 1976	2	18	Standard Wide Decompressive Laminectomy - patients with congenital stenosis
Retrospective Trial with Consecutive Patients
Crock, Shiraishi, and Crock, 1995	1	34	Partial laminectomy or hemilaminectomy	None	None	Low dose aspirin 75 mg aspirin or 100 mg dispirin CV was prescribed to be taken daily fro 3-4 months following the operation to facilitate the micro-circulation of the cauda equina and nerve roots.
Silvers, Lewis, and Asch, 1993	1	248	Standard Wide Decompressive Laminectomy	Two patients had fusion	None	None
Katz, Lipson, Larson et al., 1991	1	88	Mixed Decompression Techniques	8 patients had bilateral lateral arthrodesis, supplemented by grafting of autogenous cancellous bone from the iliac crest	None	None
Ganz, 1990	1	36	Standard Wide Decompressive Laminectomy	None	None	None
Case-series
Norcross-Nechay, Mathew, Simmons et al., 1999	1	70	Decompressive Surgery with fusion and instrumentation	Not Reported	Not Reported	None
Guigui, Benoist, Delecourt et al., 1998	1	50	Decompressive surgery	None	None	None
Scholz, Firsching, and Lanksch, 1998	1	72	Decompressive Surgery	None	None	None
Tsai, Yang, and Bray, 1998	1	62	Laminotomy	None	None	None
Mackay and Wheelwright, 1998	1	50	Partial laminectomy or hemilaminectomy	No patient received fusion.	None	None
Whitecloud, Castro Jr, Brinker et al., 1998	1	35	SWDL with Fusion and Instrumentation	Sequential anterior and posterior fusion	Titanium cages	None
Spetzger, Bertalanffy, Reinges et al., 1997	1	29	Laminotomy	None	None	None
Katz, Lipson, Chang et al., 1996	1	88	Standard Wide Decompressive Laminectomy	5 patients received arthrodesis by grafting autogenous cancellous bone from the iliac crest.	None	None
Lehto and Honkanen, 1995	1	96	Decompressive Surgery	None	None	None
Stucki, Liang, Fossel et al., 1995	1	203	Decompressive Surgery	No description of actual surgery was reported.
Tuite, Stern, Doran et al., 1994	1	119	Standard Wide Decompressive Laminectomy	None	None	None
McCullen, Bernini, Bernstein et al., 1994	1	193	Decompressive Surgery	None	None	Rest, Physiotherapy, and antiinflammatory medication.
Simmons and Simmons, 1992	1	40	SWDL with Fusion and Instrumentation	Bilateral posterolateral with bone grafting with the use of autogenous and allograft bone	Zielke 24 patients, Cotrel-Dubousset 8 patients, Texas Scottish Rite Hospital 8 patients	None
Mauersberger and Nietgen, 1989	1	92	Decompressive surgery with or without fusion	Not described	None	None
Johnsson, Redlund-Johnell, Uden et al., 1989	1	61	Standard Wide Decompressive Laminectomy	None	None	None
Brodsky, Hendricks, Khalil et al., 1989	1	34	Fusion	Not described	None	None
Jalovaara, Lahde, Iikko et al., 1989	1	31	Standard Wide Decompressive Laminectomy	None	None	None
Fast, Robin, and Floman, 1985	1	19	Standard Wide Decompressive Laminectomy	1 patient received a bilateral lateral fusion
Boccanera, Pellicioni, and Laus, 1984	1	25	Standard Wide Decompressive Laminectomy
Hood and Weigl, 1983	1	21	Standard Wide Decompressive Laminectomy
Scafuri and Weinstein, 1981	1	27	Standard Wide Decompressive Laminectomy
Echeverria and Lockwood, 1979	1	35	Standard Wide Decompressive Laminectomy	Surgery poorly described. All patients received wide and thorough decompression, including foraminotomy when indicated. No fusion was attempted.
Scapinelli, 1978	1	23	Standard Wide Decompressive Laminectomy			Lumbo-sacral support and physical therapy
Vestad and Naca, 1977	1	80	Standard Wide Decompressive Laminectomy	16 posterior intercorporal, intertransversal, or dorsal, 1 anterior fusion.
McKinley and Davis, 1976	1	32	Standard Wide Decompressive Laminectomy
Teng and Papatheodorou, 1963	1	29	SWDL-Standard Wide Decompressive Laminectomy			One patient is included in the patient information despite not having undergone any surgery. He or she is still under conservative care, which was not described.
Epstein, Epstein, and Lavine, 1962	1	29	Mixed Decompression Techniques
Epstein, 1960	1	14	Standard Wide Decompressive Laminectomy
Trials Examining Surgical Patients with Degenerative Spondylolisthesis
Randomized controlled Trial
Fischgrund, Mackay, Herkowitz et al., 1997	1	40	SWDL with Fusion and Instrumentation	Autogenous bilateral lateral intertransverse process arthrodesis	Pedicle screws, VSP, Acromed, Cleveland, Ohio	None
Fischgrund, Mackay, Herkowitz et al., 1997	2	35	SWDL with Fusion Arthrodesis	Autogenous bilateral lateral intertransverse process arthrodesis	None	None
Thomsen, Christensen, Eiskjaer et al., 1997	1	20	Partial laminectomy with fusion and instrumentation	Posterolateral intertransverse fusion with autologous bone transplantation from the right iliac wing	Cotrel-Dubousset system for pedicle screw fixation.	None
Thomsen, Christensen, Eiskjaer et al., 1997	2	21	Partial laminectomy and fusion	Posterolateral intertransverse fusion with autologous bone transplantation from the right iliac wing	None	None
Bridwell, Sedgewick, O'Brien et al., 1993	1	9	Partial laminectomy or hemilaminectomy	None	None	None
	2	10	Partial laminectomy and fusion	Posterolateral transverse processes, autogenous iliac bone graft	None	None
	3	24	Partial laminectomy with fusion and instrumentation	Posterolateral transverse processes, autogenous iliac bone graft	Pedicle fixation using Steffee plates	None
Herkowitz and Kurz, 1991	1	25	SWDL-Standard Wide Decompressive Laminectomy	None	None	None
Herkowitz and Kurz, 1991	2	25	SWDL with Fusion Arthrodesis	Single level bilateral intertransverse-process arthrodesis with autologous bone from the iliac crest	None	None
Controlled Trials
Plotz and Benini, 1998	1	17	Decompressive Surgery without fusion
	2	18	Decompressive Surgery with fusion and Translaminar Screw Fixation		Translaminar Screw Fixation
	3	71	Decompressive Surgery with fusion and AO Internal Fixator		AO Internal Fixator of Dick
Yuan, Garfin, Dickman et al., 1994	1	2177	Fusion and Pedical Screw Fixation	Posterior autograft	Screws or bolts that could be inserted into spinal pedicles for the fixation of the spine	None
Yuan, Garfin, Dickman et al., 1994	2	456	Fusion	Posterior autograft	None	None
Satomi, Hirabayashi, Toyama et al., 1992	1	27	Fusion and instrumentation	Anterior lumbar interbody fusion	21 of 27 patients received AO screwing and wiring	None
Satomi, Hirabayashi, Toyama et al., 1992	2	14	Mixed Decompression Techniques	8 interlaminal fenestration, 5 laminectomy, 1 fusion and Luque rods.	None	None
Lombardi, Wiltse, Reynolds et al., 1985	1	20	SWDL-Standard Wide Decompressive Laminectomy
Lombardi, Wiltse, Reynolds et al., 1985	2	21	SWDL with Fusion Arthrodesis
Prospective Trials
Nakai, Yoshizawa, and Kobayashi, 1999	1	23	Fusion only	Posterior lumbar intervertebral fusion without laminectomy preserving the interspinous process ligament.
Rechtine, Sutterlin, Wood et al., 1996	1	18	SWDL with Fusion and Instrumentation	transverse processes posterolateral autogenous bone grafts	Interpedicular Segmental Fixation system from Sofamor Danek United States	None
Retrospective Trial with Consecutive Patients
Stambough, 1999	1	35	SWDL with Fusion and Instrumentation	Autogenous bone graft with some fresh frozen allographic augmentation	Wide variety of pedicular screw fixation and instrumentation	Custom-molded thoracolumbosacral brace
Nishizawa and Fujimura, 1997	1	58	Fusion and instrumentation	Anterior lumbar interbody fusion, grafts of cortico-cancellous bone were taken from the anterior iliac crest	A-O screws and wire were used in 48 of 58 patients	Body cast for 27 to 43 days, corset for 3 to 9 months
Moller, Wittenberg, Nolte et al., 1992	1	37	Fusion	Posterolateral fusion with an autologous corticocancellous H-graft from the iliac crest wedged between the spinous processesL4 and S1.	None	A lumbar brace was used for an average of 4.9 months.Patients had intense isometric training to strengthen the trunk muscles.
Marchesi, Thalgott, and Aebi, 1991	1	30	SWDL with Fusion and Instrumentation	Not described	AO internal fixation system using screws	Some patients were put in braces
Takahashi, Kitahara, Yamagata et al., 1990	1	39	Fusion	Anterior interbody fusion	None	None
Knox, Harvell, Nelson et al., 1989	1	39	SWDL with Fusion and Instrumentation	Autogenous iliac crest bone graft	16 -gauge wire and Luque rectangle	Corset was worn for 3 months. Of the final 24 that were available to return and fill out questionnaires 13 were women and 11 were men.
Case-series
Booth, Bridwell, Eisenberg et al., 1999	1	49	Partial laminectomy with fusion and instrumentation	Intertransverse process fusion	Constrained pedicle screw-plate or rod systems
McCulloch, 1998	1	21	Partial laminectomy and fusion	Unilateral fusion with autograft bon
Epstein, 1998b	1	28	SWDL with Fusion and Instrumentation	Texas Scottish Rite Hospital Instrumented Fusion	Not Stated
Mochida, Toh, Suzuki et al., 1997	1	10	Partial laminectomy with fusion and instrumentation	Posterior Lumbar Interbody Fusion	Leeds-Keio artificial ligament
Epstein, 1998a	1	290	Mixed Decompression Techniques
Grob, Humke, and Dvorak, 1996	1	18	SWDL with Fusion and Instrumentation	posterolateral fusion with bone graft from the iliac crest.	Two 6.5mm spongious screws	Physiotherapy, epidural injection, brace, anti-inflammatory medication. Soft brace for 3 months.
Herron and Trippi, 1989	1	24	Standard Wide Decompressive Laminectomy
Chang and McAfee, 1989	1	17	SWDL with Fusion and Instrumentation	bilateral posterolateral fusion	combination segmental rod-plate and transpedicular spinal fixator	3 patients had scoliosis rather than spondylolisthesis.
Inoue, Watanabe, Goto et al., 1988	1	36	Fusion
Simmons and Capicotto, 1988	1	15	SWDL with Fusion and Instrumentation	Bilateral posterolateral bone graft of the instrumented segments	Zielke screws and rods.
Hanley, 1986	1	20	SWDL with Fusion and Instrumentation	Autologous iliac crest bone graft over the decorticated transverse process and lateral aspects of the pedicles and facet joints at the operated segments	Harrington distraction rods with #1254 hooks inferiorly and #1253 hooks superiorly
Kaneda and Kazama, 1986	1	54	SWDL with Fusion and Instrumentation	Posterolateral	Combined distraction and compression rod instrumentation.
Alexander Jr, Kelly Jr, Davis Jr et al., 1985	1	50	Standard Wide Decompressive Laminectomy	4 patients had undescribed fusion.
Dall and Rowe, 1985	1	26	SWDL-Standard Wide Decompressive Laminectomy
Epstein, Epstein, Carras et al., 1983	1	60	Mixed Decompression Techniques
Richardson and Brown, 1980	1	21	SWDL with Fusion Arthrodesis	Posterolateral fusion	None	None
Cauchoix, Benoist, and Chassaing, 1976	1	26	SWDL-Standard Wide Decompressive Laminectomy	None	None	Not described. Text stated that conservative care was adequate for some patients.
Epstein, Epstein, Lavine et al., 1976	1	20	Mixed Decompression Techniques	2 patients had fusion	None	None
Trials Examining Surgical Patients with LumbarStenosis and/or Degenerative Spondylolisthesis
Controlled Trial
Rompe, Eysel, Zollner et al., 1999	1	39	Partial laminectomy or hemilaminectomy - patients with central lumbar stenosis	None	None	None
	2	51	SWDL-Standard Wide Decompressive Laminectomy - patients with central lumbar stenosis	None	None	None
	3	27	SWDL with Fusion and Instrumentation - patients with degenerative spondylolisthesis	Intertransverse autogenous bone graft	Cotrel-Dubousset-pedicle screw fixation.	None
Katz, Lipson, Lew et al., 1997	1	194	Standard Wide Decompressive Laminectomy	None	None	None
	2	37	SWDL with Fusion Arthrodesis	Intertransverse autogenous bone graft.	None	None
	3	41	SWDL with Fusion and Instrumentation	Intertransverse autogenous bone graft.	Several types	None
Sato and Kikuchi, 1997	1	28	Laminotomy - 2 level stenosis
Sato and Kikuchi, 1997	2	53	Laminotomy - 1 level stenosis
Rompe, Eysel, Hopf et al., 1995	1	24	SWDL with Fusion and Instrumentation - patients with lumbar stenosis	4 patients with posterior fusion and supplemental bone grafting	4 patients with Cotrel-Dubousset-Instrumentation pedicle screws	None
	2	24	Standard Wide Decompressive Laminectomy - patients with lumbar stenosis	None	None	None
	3	12	SWDL with Fusion and Instrumentation - patients with lumbar stenosis and spondylolisthesis	posterior fusion	9 patients with Cotrel-Dubousset-Instrumentation pedicle screws, 3 patients with hook system	None
Sanderson and Wood, 1993	1	19	Partial laminectomy or hemilaminectomy - patients with Degenerative Spondylolisthesis	None	None	None
Sanderson and Wood, 1993	2	12	SWDL-Standard Wide Decompressive Laminectomy - patients with lumbar spinal stenosis	None	None	None
Robertson, Grobler, Novotny et al., 1993	1	22	SWDL-Standard Wide Decompressive Laminectomy - patients with central lumbar stenosis	None	None	None
Robertson, Grobler, Novotny et al., 1993	2	11	SWDL-Standard Wide Decompressive Laminectomy - patients with degenerative spondylolisthesis	None	None	None
Postacchini, Cinotti, Perugia et al., 1993	1	26	Laminotomy - patients with congenital or degenerative stenosis, combined, or degenerative spondylolisthesis	4 patients with deg. spondylolisthesis had intertransverse fusion	None
Postacchini, Cinotti, Perugia et al., 1993	2	41	Standard Wide Decompressive Laminectomy - patients with central lumbar stenosis	8 patients with deg. spondylolisthesis had intertransverse fusion	None
Hirabayashi, Kumano, and Kuroki, 1991	1	32	SWDL with Fusion and Instrumentation - patients with degenerative spondylolisthesis	posterior lumbar interbody fusion	Cotrel-Dubousset pedicle screw system	None
Hirabayashi, Kumano, and Kuroki, 1991	2	21	SWDL with Fusion and Instrumentation - patients with lumbar stenosis	posterior lumbar interbody fusion	Cotrel-Dubousset pedicle screw system	None
Herkowitz and Garfin, 1989	1	58	Standard Wide Decompressive Laminectomy - patients with degenerative stenosis
Herkowitz and Garfin, 1989	2	41	Standard Wide Decompressive Laminectomy - patients with degenerative spondylolisthesis
Prospective Trial
Jonsson, Annertz, Sjoberg et al., 1997a	1	105	Partial laminectomy or hemilaminectomy - patients with Central Spinal Stenosis and Degenerative Spondylolisthesis	None
Postacchini and Conotti, 1992	1	88	Mixed Decompression Techniques - patients with Developmental, degenerative, or combined, with or without Spondylolisthesis	10 patients had intertransverse fusion
Retrospective Trial with Consecutive Patients
Chen, Baba, Kamitani et al., 1994	1	80	Mixed Decompression Techniques - patients with Developmental, degenerative, or combined stenosis, or degenerative or isthmic spondylolisthesis	20 patients with spondylolisthesis had a intertransverse fusion	8 patients had Cotrel Dubousset transpedicular fixation	None
Postacchini, Cinotti, Gumina et al., 1993	1	64	Mixed Decompression Techniques - patients with Developmental, degenerative, or combined, with or without spondylolisthesis	17 patients with intertransverse fusion	None	None
Case-series
Guigui, Barre, Benoist et al., 1999	1	28	SWDL-Standard Wide Decompressive Laminectomy	2 patients had posterolateral fusion	None	None
Trials Examining Surgical Patients and Patients Receiving Conservative Treatment
Patients with Central Lumbar Stenosis
Simotas, Dorey, Hansraj et al., 2000	1	40	Conservative - various treatment			1 to 2 weeks of bed rest for patients with acute motor weakness, oral corticosteroids on a 7-day tapering schedule for significant radiculopathy, epidural corticosteroid injections for nonresponding patients, NSAIDs for less severe patients. All patients were placed in a physical rehabilitation program with a physical therapist and instructed to perform a flexion-biased lumbar stabilization exercise on a daily basis.
Simotas, Dorey, Hansraj et al., 2000	2	9	Surgery - not described			Conservative therapy lasted a mean of 13 months, range 2 to 41 before these 9 patients needed surgery. All patients were placed in a physical rehabilitation program with a physical therapist and instructed to perform a flexion-biased lumbar stabilization exercise on a daily basis.
Mariconda, Zanforlino, Celestino et al., 2000	1	20	Standard Wide Decompressive Laminectomy
Mariconda, Zanforlino, Celestino et al., 2000	2	17	Untreated
Johnsson, Uden, and Rosen, 1991	1	20	Conservative-not described	None	None	Not described
	2	30	Standard Wide Decompressive Laminectomy - patients with moderate stenosis	None	None	None
	3	14	Standard Wide Decompressive Laminectomy - patients with severe stenosis	None	None	None
Patients with Central or Lateral Lumbar Stenosis Unspecified
Amundsen, Weber, Nordal et al., 2000	1	19	Standard wide decompressive laminectomy	None		After 1 to 2 days patients received a brace; rehabilitation lasted 1 month followed by back school
	2	50	Conservative - various treatments			Patients were fitted with a brace, given rehabilitation for 1 month, and "back school" training; after 2 months physiotherapy was started, including general physical training
	3	13	Standard wide decompressive laminectomy	None		After 1 to 2 days patients received a brace; rehabilitation lasted 1 month followed by back school
	4	18	Conservative - various treatments			Patients were fitted with a brace, given rehabilitation for 1 month, and "back school" training; after 2 months physiotherapy was started, including general physical training
Hurri, Slatis, Soini et al., 1998	1	57	SWDL-Standard Wide Decompressive Laminectomy	None	None	None
Hurri, Slatis, Soini et al., 1998	2	18	Conservative-not described	None	None	The conservative treatment was not described and referred to only as nonoperative treatment.
Atlas, Deyo, Keller et al., 1996	1	81	SWDL-Standard Wide Decompressive Laminectomy	3 patients received fusion	None	None
Atlas, Deyo, Keller et al., 1996	2	67	Conservative-many	None	None	Bed rest 27%, back exercises 39%, Traction 4%, Brace 14%, TENS 14%, Physical Therapy 23%, Spinal Manipulation 23%, Other therapies 5%, Epidural Steroids 18%, Narcotic analgesics use in past week 21%.
Atlas, Keller, Robson et al., 2000	1	67	SWDL-Standard Wide Decompressive Laminectomy	Four year followup for Atlas, Deyo, Keller et al., 1996
Atlas, Keller, Robson et al., 2000	2	52	Conservative-many	Four year followup for Atlas, Deyo, Keller et al., 1996
Swezey, 1996	1	12	Exercise/stretching and flexibility	None	None	Ergonomics and flexion exercises plus analgesic and nonsteroidal anti-inflammatory drugs.
	2	11	Physical Therapy/massage, ultrasound, heat, ice, traction	None	None	Outpatient pelvic traction using static traction on a split-traction table given once or twice weekly for 20 minutes at 50% of body weight. Ergonomics and flexion exercises plus analgesic and nonsteroidal anti-inflammatory drugs.
	3	13	Epidural Steroid Injections	None	None	Epidural corticosteroid injections when other measures were not providing sufficient relief from neurogenic claudication.Maximum of 3 injections at no less than 1-2 week intervals. Ergonomics and flexion exercises plus analgesic and nonsteroidal anti-inflammatory drugs.
	4	11	Standard Wide Decompressive Laminectomy	None	None	None
Nagler and Bodack, 1993	1	41	Conservative-various types	None	None	Analgesics, electrical stimulation, ice, heat, hydrotherapy, ultrasound, muscle relaxation techniques, stretching and strengthening exercises, and treadmill training.
Nagler and Bodack, 1993	2	39	Standard Wide Decompressive Laminectomy	None	None	None
Herno, Airaksinen, Saari et al., 1996	1	54	Conservative-not described	None	None	Conservative therapy was not described.Patients were considered nonoperative.
Herno, Airaksinen, Saari et al., 1996	Data from surgical patients used for comparison were obtained from a larger previously published study.
Patients with Degenerative Spondylolisthesis
Fitzgerald and Newman, 1976	1	29	Rigid Brace	None	None	Lumbo-sacral corset
Fitzgerald and Newman, 1976	2	14	Mixed Decompression Techniques	Postero-lateral grafts over the transverse processes and adjoining outer parts of the facets and pedicles.	None	None
Rosenberg, 1976	1	11	Partial laminectomy or hemilaminectomy	None	None	None
	2	15	Standard Wide Decompressive Laminectomy	None	None	None
	3	170	Conservative-not described	None	None	Patients received analgesics, anti-inflammatory medication, bracing, bed rest, exercise, traction and different thermal modalities with unpredictable ability to relief pain.Symptomatic therapy was adequate in 90% of patients.

Evidence Table 10. Patient Characteristics Information for Clinical Trials of Patients with Lumbar Spinal Stenosis

Randomized controlled Trials of Patients Receiving Conservative Treatments
First Author and Year of Publication	Patient Group	N	Treatment	Males	Females	Dropouts			Age years				Duration of Condition months				Levels Involved			PriorSurgery
First Author and Year of Publication	Patient Group	N	Treatment	Males	Females	Total	Deaths	Lost to Followup	Mean	SD	Youngest	Oldest	Mean	SD	Minimum	Maximum	Single	Multiple	Mean	PriorSurgery
Patients with Central or Lateral Lumbar Stenosis type of stenosis unspecified or includes both types of stenosis
Fukusaki, Kobayashi, Hara et al., 1998	1	16	Epidural Saline	12	4	0	0	0	70	8			2.63	2			0	0	0
	2	18	Epidural Anesthetics	13	5	0	0	0	69	9			2.73	2.27			0	0	0
	3	19	Epidural Anesthetics and Steroids	13	6	0	0	0	72	7			3.13	2.63			0	0	0
Eskola, Pohjolainen, Alaranta et al., 1992	1	20	Calcitonin Injections	10	10	0	0	0	56.3		26	74	68.4		24	120	0	0	0	0
Eskola, Pohjolainen, Alaranta et al., 1992	2	19	Calcitonin Injections	10	9	0	0	0	55.7		38	71	75.4		24	144	0	0	0	0
Cuckler, Bernini, Wiesel et al., 1985	1	20	Epidural Anesthetics and Steroids	10	10	0			48.5	1.3			36.6	12.5
Cuckler, Bernini, Wiesel et al., 1985	2	17	Epidural Anesthetics	10	7	0			49.5	2.8			29.4	14.3
Patients with Degenerative Spondylolisthesis
Sinaki, Lutness, Ilstrup et al., 1989	1	29	Exercise/flexion	12	14	3	0	3	44.5	14.5			46.8	70.8			0	0	0
Sinaki, Lutness, Ilstrup et al., 1989	2	19	Exercise/extension	6	12	1	1		44.3	15.7			48	55.2			0	0	0
Trials Examining Surgical Patients with Central Lumbar Stenosis
Randomized controlled Trial
Grob, Humke, and Dvorak, 1995	1	15	Partial laminectomy or hemilaminectomy	6	9	0			66		48	72	16		6	37				0
	2	15	Partial laminectomy with fusion and instrumentation for single level	10	5	0			71		56	87	16		6	37	15	0	1	0
	3	15	Partial laminectomy with fusion and instrumentation for multiple levels	5	10	0			71		58	79	16		6	37		15		0
Controlled Trials
Herno, Saari, Suomalainen et al., 1999	1	35	Mixed Decompression Techniques - no post-surgery stenosis	16	19				52.9				40							0
Herno, Saari, Suomalainen et al., 1999	2	57	Mixed Decompression Techniques - post-surgery stenosis	28	29				51.4				2.4							0
Herno, Partanen, Talaslahti et al., 1999	1	41	Standard Wide Decompressive Laminectomy post surgery stenosis	25	16				55.1										1.7
Herno, Partanen, Talaslahti et al., 1999	2	15	Standard Wide Decompressive Laminectomy no post surgery stenosis	6	9				52										1.6
Hanakita, Suwa, and MIzuno, 1999	1	59	Standard Wide Decompressive Laminectomy SWDL									64
	2	61	Standard Wide Decompressive Laminectomy								65
	3	16	Partial laminectomy or hemilaminectomy									64
	4	20	SWDL with Fusion Arthrodesis									64
Thomas, Rea, Pikul et al., 1997	1	12	Standard Wide Decompressive Laminectomy						68		40	86								0
Thomas, Rea, Pikul et al., 1997	2	14	Laminotomy						68		40	86								0
Yone, Sakou, Kawauchi et al., 1996	1	10	SWDL with Fusion and Instrumentation	4	6				68		60	89					3	7	1.7
Yone, Sakou, Kawauchi et al., 1996	2	17	Laminotomy	12	5				68		60	78					5	12	2.2
Ray, 1982	1	48	Standard Wide Decompressive Laminectomy	30	18				54.3				173				25	23	1.67
Ray, 1982	2	17	Partial laminectomy or hemilaminectomy	12	5				45.5				83				9	8	1.65
Surin, Hedelin, and Smith, 1982	1	15	Standard Wide Decompressive Laminectomy - marked stenosis	13	9	0	0	0	64		47	76					4	18
Surin, Hedelin, and Smith, 1982	2	7	Standard Wide Decompressive Laminectomy - moderate stenosis	13	9				64		47	76					4	18
Tajima, Fukazawa, and Ishio, 1980	1	13	Mixed Decompression Techniques	11	2				46.9		35	55					6	7	1.5
Tajima, Fukazawa, and Ishio, 1980	2	14	Mixed Decompression Techniques - disk lesion	12	2				49.3		35	55					9	5	1.4
Prospective Trials
Kleeman, Hiscoe, and Berg, 2000	1	54	Partial Laminectomy	30	24	6	0	6	71		51	86					18	36	2.02	0
Weiner, Wlaker, Brower et al., 1999	1	30	Partila Laminectomy	14	16	0	0	0	68		41	81	24		3	96	9	21	2.07
diPierro, Helm, Shaffrey et al., 1996	1	35	Hemilaminectomy and fusion	11	18	6	0	6	64		33	80					0	29	2.93	9
Retrospective Trial with Consecutive Patients
Vitaz, Raque, Shields et al., 1999	1	65	Mixed Decompression Techniques	22	43	4		4	78								15	50	2.5	20
Matsui, Kanamori, Ishihara et al., 1997	1	27	SWDL with Fusion Arthrodesis	20	7				53.3		37	69					0	27	3.2
Airaksinen, Herno, Turunen et al., 1997	1	497	Standard Wide Decompressive Laminectomy	255	183	59	33	26	53	10			84						1.5	99
Mullin, Rea, Irsik et al., 1996	1	72	Standard Wide Decompressive Laminectomy	16	8	48			63.1	11.8	31	78
Ishac, Alhayek, Fournier et al., 1996	1	34	Standard Wide Decompressive Laminectomy	21	13	0			83		80	87			6		1	33	3
Jonsson and Stromqvist, 1994	1	43	Partial laminectomy or hemilaminectomy			3	1	2			71	84	48				12	31	2.3	9
Caputy and Luessenhop, 1992	1	100	Standard Wide Decompressive Laminectomy	46	54				67		43	84	6		1	144	21	79		4
Dhar and Porter, 1992	1	36	Standard Wide Decompressive Laminectomy
Chahal, Mundkur, Sancheti et al., 1982	1	32	Standard Wide Decompressive Laminectomy	22	10				42.8		21	70	51		3	240	13	19	1.75
Rosomoff, 1981	1	50	Standard Wide Decompressive Laminectomy	20	30						25	75			6	120	10	40	2.2	36
Getty, 1980	1	35	Standard Wide Decompressive Laminectomy	16	15	7	0	4	58		30	75	69.6						2.5
Reale, Deifini, Gambacona et al., 1978	1	37	Standard Wide Decompressive Laminectomy - congenital stenosis	27	10	4	0	4	52.5		30	75
Verbiest, 1977	1	116	Standard Wide Decompressive Laminectomy - congenital stenosis			24	1	24			22	85
Case-series
Young, Veerapen, and O'Laoire, 1988	1	32	Decompressive Surgery	17	15															2
Kurihara, Tanaka, Tsumura et al., 1988	1	12	Standard Wide Decompressive Laminectomy - hyperostotic stenosis	6	6				56		42	72
Hall, Bartleson, Onofrio et al., 1985	1	68	Standard Wide Decompressive Laminectomy	53	15	6	3	3	63		32	83	32		1	120	3	65	3	0
Weinstein, Scafuri, and McNeill, 1983	1	24	Standard Wide Decompressive Laminectomy																3
Weir and De Leo, 1981	1	81	Standard Wide Decompressive Laminectomy	57	24				53.3		30	80
Johnsson, Willner, and Pettersson, 1981	1	27	Standard Wide Decompressive Laminectomy	22	5	0	0	0	61.3	9	48	80	25	22	1	84	4	23	2.4
Verbiest, 1979	1	11	SWDL with Fusion Arthrodesis - congenital lumbar stenosis	3	8				19.3	10.5	11	42					7	4	1.45
Salibi, 1976	1	19	Standard wide laminectomy 16 patients and unilateral laminectomy 3 patients	17	3	1			60		36	76					3	17		2
Trials Examining Surgical Patients with Lateral Lumbar Stenosis
Randomized controlled Trial
Lee and deBari, 1986	1	12	SWDL with Fusion Arthrodesis						45.7		28	65						12
Lee and deBari, 1986	2	12	SWDL with Fusion and Instrumentation						45.7		28	65						12
Controlled Trials
Kirkaldy-Willis, Wedge, Yong-Hing et al., 1982	1	20	Partial laminectomy or hemilaminectomy			5			46		41	52	132		108	156				0
	2	32	Partial laminectomy or hemilaminectomy - with disk herniation			6			46		41	52	132		108	156				0
	3	21	Partial laminectomy or hemilaminectomy - Lateral and Central Stenosis			3			46		41	52	132		108	156				0
	4	21	Partial laminectomy or hemilaminectomy - Lateral and Central Stenosis and disk herniation						46		41	52	132		108	156				0
Mikhael, Ciric, Tarkington et al., 1981	1	35	Standard Wide Decompressive Laminectomy						51				48		6	120
Mikhael, Ciric, Tarkington et al., 1981	2	50	Control/Placebo/None						51
Retrospective Trial with Consecutive Patients
Sanderson and Getty, 1996	1	66	Laminotomy	24	33	9	3	6	56		36	74	65		6	180	51	6	1.1
Baba, Uchida, Maezawa et al., 1996	1	31	Laminotomy	19	12				49.1		37	76					31		1
Aryanpur and Ducker, 1990	1	32	Laminotomy	8	24				66		31	83					9	23	2	0
Case-series
Choudhury and Taylor, 1977	1	28	Standard Wide Decompressive Laminectomy	19	9						17	61
Epstein, Epstein, Rosenthal et al., 1972	1	15	Foraminotomy/nerve root decompression	8	7						17	51
Trials Examining Surgical Patients with Central or Lateral Lumbar Stenosis type of stenosis unspecified or includes both types of stenosis
Controlled Trial
Yone and Sakou, 1999	1	14	Laminotomy - patients with instability	10	4				63		45	79					6	8	1.93
	2	19	Laminotomy with Fusion and Instrumentation - patients with instability	12	7				61		55	76					11	8	1.58
	3	27	Laminotomy - patients without instability	17	10				58		32	76					5	22	2.15
Epstein, 1999	1	10	Standard Wide Decompressive Laminectomy - patients with Ossification of the Posterior Longitudinal Ligament	5	5				62.5	13.2	38	77					1	9	3.2
Epstein, 1999	2	11	Standard Wide Decompressive Laminectomy - patients with Ossification of the Yellow Ligament	4	7				69.2	7.7	52	78					4	7	3.36
Javid and Hadar, 1998	1	86	Standard Wide Decompressive Laminectomy - patients with central stenosis	43	43				64.7		27	89	42						2.5	0
	2	61	Standard Wide Decompressive Laminectomy - patients with central stenosis and herniated disks	39	22				59.1		23	82	79						2.16	0
	3	23	Standard Wide Decompressive Laminectomy - patients with lateral stenosis	14	9				53.6		25	79	38							0
Kalbarczyk, Lukes, and Seiler, 1998	1	93	Standard Wide Decompressive Laminectomy - patients without instability			0			76		70	88
	2	46	Partial laminectomy or hemilaminectomy - patients with mild instability			0			76		70	88
	3	9	Partial laminectomy and fusion - patients with high instability			1	1		76		70	88
Pai and Kumar, 1996	1	30	Decompressive Surgery - patients with congenital stenosis						36
Pai and Kumar, 1996	2	23	Decompressive Surgery - patients with degenerative stenosis						52
Kawauchi, Yone, and Sakou, 1996	1	7	Partial laminectomy and fusion - patients with slight adhesions	24	12	0	0	0	60.6		39	78	46		2	132	7	0	1	0
	2	16	Partial laminectomy and fusion- patients with moderate adhesions	24	12	0	0	0	60.6		39	78	46		2	132	16	0	1	0
	3	13	Partial laminectomy and fusion- patients with marked adhesions	24	12	0	0	0	60.6		39	78	46		2	132	13	0	1	0
Cinotti, Postacchini, and Weinstein, 1994	1	25	Standard Wide Decompressive Laminectomy - patients with diabetes	14	11	0			68		37	84	19
Cinotti, Postacchini, and Weinstein, 1994	2	25	Standard Wide Decompressive Laminectomy - patients without diabetes	13	12	0			71		58	84	16
Little and MacDonald, 1994	1	60	SWDL with Fusion Arthrodesis						50.6
Little and MacDonald, 1994	2	34	SWDL with Fusion Arthrodesis						50.6
Simpson, Silveri, Balderston et al., 1993	1	33	Standard Wide Decompressive Laminectomy - patients with diabetes			9			63		32	84
Simpson, Silveri, Balderston et al., 1993	2	24	Standard Wide Decompressive Laminectomy - patients without diabetes			2			63		32	84
Jonsson and Stromqvist, 1993a	1	20	Partial laminectomy or hemilaminectomy - patients with central stenosis			1	1	0												20
Jonsson and Stromqvist, 1993a	2	19	Partial laminectomy or hemilaminectomy - patients with lateral stenosis			1	1													19
Nasca, 1989	1	15	Decompressive Surgery -patients with lateral lumbar stenosis	9	6				47
	2	29	Decompressive Surgery - patients with central or combined lumbar stenosis														23	6
	3	16	Decompressive Surgery with fusion and instrumentation - patients with central or combined lumbar stenosis	9	7				56								7	9
	4	21	Decompressive Surgery - patients with postsurgical stenosis
	5	22	Decompressive Surgery with fusion and instrumentation - patients with instability	10	12				55
	6	11	Decompressive Surgery with fusion and instrumentation - patients with degenerative stenosis and scoliosis	0	11				63
Nather and Thomas, 1985	1	11	Decompressive surgery with or without fusion - patients with degenerative lumbar stenosis
Nather and Thomas, 1985	2	14	Decompressive surgery with or without fusion - patients with combined degenerative and congenital lumbar stenosis
Paine, 1976	1	95	Standard Wide Decompressive Laminectomy - patients with degenerative stenosis														39	56		10
Paine, 1976	2	48	Standard Wide Decompressive Laminectomy- patients with degenerative stenosis and disk herniation
Shenkin and Hash, 1976	1	49	Standard Wide Decompressive Laminectomy - patients with no prior surgery	27	22	3		3	59.4		45	84								0
Shenkin and Hash, 1976	2	21	Standard Wide Decompressive Laminectomy - patients with prior surgery for herniated disk	11	10	0			55.7		33	75								21
Tile, McNeil, Zarins et al., 1976	1	26	Mixed Decompression Techniques - patients with lumbar stenosis
Tile, McNeil, Zarins et al., 1976	2	18	Standard Wide Decompressive Laminectomy - patients with congenital stenosis
Retrospective Trial with Consecutive Patients
Crock, Shiraishi, and Crock, 1995	1	34	Partial laminectomy or hemilaminectomy	15	19	0			64		29	88	53		24		0	34	3.5	60
Silvers, Lewis, and Asch, 1993	1	248	Standard Wide Decompressive Laminectomy	97	147	4	4	0	65	0.6	30	87	21.6	3.3	0	480	108	140	1.82	47
Katz, Lipson, Larson et al., 1991	1	88	Mixed Decompression Techniques	26	62	18	8	10	69.3		55	89	19				16	72	2.4	0
Ganz, 1990	1	36	Standard Wide Decompressive Laminectomy	29	4	3	1	1	57	14.7	21	84							2.5
Case-series
Norcross-Nechay, Mathew, Simmons et al., 1999	1	70	Decompressive Surgery with fusion and instrumentation						46	13.1							0
Guigui, Benoist, Delecourt et al., 1998	1	50	Decompressive surgery	22	28				60		31	85					14	36	2.26
Scholz, Firsching, and Lanksch, 1998	1	72	Decompressive Surgery	32	40				59.7				72
Tsai, Yang, and Bray, 1998	1	62	Laminotomy	31	19	12			66		35	85	79		1	480	13	37	1.88	0
Mackay and Wheelwright, 1998	1	50	Partial laminectomy or hemilaminectomy	24	26	2	2		61		36	81	33.6		6	240	23	27	1.6
Whitecloud, Castro Jr, Brinker et al., 1998	1	35	SWDL with Fusion and Instrumentation	19	16				45.3	11.2	26	76					13	22	1.8	29
Spetzger, Bertalanffy, Reinges et al., 1997	1	29	Laminotomy	14	15	4		4	62		34	83	42		3	180	22	7	1.28
Katz, Lipson, Chang et al., 1996	1	88	Standard Wide Decompressive Laminectomy			33	20	13	69.3		55	88					16	72	2.38
Lehto and Honkanen, 1995	1	96	Decompressive Surgery	46	50	31	7	24	59		26	87	2.7		2	16	59	37	1.48	41
Stucki, Liang, Fossel et al., 1995	1	203	Decompressive Surgery	46	84	100			68	9.1
Tuite, Stern, Doran et al., 1994	1	119	Standard Wide Decompressive Laminectomy	63	56				61.8	11	46	80			6	60			2.5	0
McCullen, Bernini, Bernstein et al., 1994	1	193	Decompressive Surgery	42	76	75		75	69		46	91	39		11	480	9	109	2.81	23
Simmons and Simmons, 1992	1	40	SWDL with Fusion and Instrumentation	15	25	0			61.5		38	77
Mauersberger and Nietgen, 1989	1	92	Decompressive surgery with or without fusion			26	4	9							1	360	49	43
Johnsson, Redlund-Johnell, Uden et al., 1989	1	61	Standard Wide Decompressive Laminectomy	40	21		1		65		38	80	27	30	1	180
Brodsky, Hendricks, Khalil et al., 1989	1	34	Fusion			2
Jalovaara, Lahde, Iikko et al., 1989	1	31	Standard Wide Decompressive Laminectomy	19	12	0	0	0	52		37	79	72		12	120	14	17	1.8	0
Fast, Robin, and Floman, 1985	1	19	Standard Wide Decompressive Laminectomy	9	10				67		50	80			1	240	0
Boccanera, Pellicioni, and Laus, 1984	1	25	Standard Wide Decompressive Laminectomy	18	7				61		49	73								6
Hood and Weigl, 1983	1	21	Standard Wide Decompressive Laminectomy	15	6	1	1				50	75			60	360	0	20	3.4
Scafuri and Weinstein, 1981	1	27	Standard Wide Decompressive Laminectomy	12	15	2			57.1		26	75	116		2	456	8	17	3.12
Echeverria and Lockwood, 1979	1	35	Standard Wide Decompressive Laminectomy	27	8	15		8	57.5		28	82	36		12	240				10
Scapinelli, 1978	1	23	Standard Wide Decompressive Laminectomy			0	0	0			25	60
Vestad and Naca, 1977	1	80	Standard Wide Decompressive Laminectomy						39.6		15	65
McKinley and Davis, 1976	1	32	Standard Wide Decompressive Laminectomy	15	17	14			51		17	75	49				32		1
Teng and Papatheodorou, 1963	1	29	SWDL-Standard Wide Decompressive Laminectomy	22	8						37	72			0	240	2		2.7
Epstein, Epstein, and Lavine, 1962	1	29	Mixed Decompression Techniques	15	14
Epstein, 1960	1	14	Standard Wide Decompressive Laminectomy	8	6						29	66			1	480
Trials Examining Surgical Patients with Degenerative Spondylolisthesis
Randomized controlled Trial
Fischgrund, Mackay, Herkowitz et al., 1997	1	40	SWDL with Fusion and Instrumentation	7	28	5		5	69		53	86					35		1	0
Fischgrund, Mackay, Herkowitz et al., 1997	2	35	SWDL with Fusion Arthrodesis	6	27	2		2	66		52	80					35		1	0
Thomsen, Christensen, Eiskjaer et al., 1997	1	20	Partial laminectomy with fusion and instrumentation						46		20	67
Thomsen, Christensen, Eiskjaer et al., 1997	2	21	Partial laminectomy and fusion						43.5		20	66
Bridwell, Sedgewick, O'Brien et al., 1993	1	9	Partial laminectomy or hemilaminectomy	2	7	0			72.3								9		1	0
	2	10	Partial laminectomy and fusion	4	6	0			65.6								10		1	0
	3	24	Partial laminectomy with fusion and instrumentation	4	24	0			64.2								23	1	1.04	0
Herkowitz and Kurz, 1991	1	25	SWDL-Standard Wide Decompressive Laminectomy	9	16	0			65		53	83					25		1
Herkowitz and Kurz, 1991	2	25	SWDL with Fusion Arthrodesis	5	20	0			63.5		52	84					25		1
Controlled Trials
Plotz and Benini, 1998	1	17	Decompressive Surgery without fusion	2	15				64		45	85
	2	18	Decompressive Surgery with fusion and Translaminar Screw Fixation	8	10				67		57	83
	3	71	Decompressive Surgery with fusion and AO Internal Fixator	2	15				67		45	83
Yuan, Garfin, Dickman et al., 1994	1	2177	Fusion and Pedical Screw Fixation	817	1360				57.8								1868	309	1.1	738
Yuan, Garfin, Dickman et al., 1994	2	456	Fusion	140	316				61.3								415	41	1.1	92
Satomi, Hirabayashi, Toyama et al., 1992	1	27	Fusion and instrumentation			0			51.1		36	65	46
Satomi, Hirabayashi, Toyama et al., 1992	2	14	Mixed Decompression Techniques			0			68.6		60	81	104
Lombardi, Wiltse, Reynolds et al., 1985	1	20	SWDL-Standard Wide Decompressive Laminectomy						65		49	81
Lombardi, Wiltse, Reynolds et al., 1985	2	21	SWDL with Fusion Arthrodesis						65		49	81
Prospective Trials
Nakai, Yoshizawa, and Kobayashi, 1999	1	23	Fusion only	2	16	5		2	52.8	7.4	42	68					23		1
Rechtine, Sutterlin, Wood et al., 1996	1	18	SWDL with Fusion and Instrumentation	4	14	0			55	13.4	33	74					10	8	1.67	14
Retrospective Trial with Consecutive Patients
Stambough, 1999	1	35	SWDL with Fusion and Instrumentation						52.2		18	85
Nishizawa and Fujimura, 1997	1	58	Fusion and instrumentation	13	45	0			53		28	68					56	2	1.03
Moller, Wittenberg, Nolte et al., 1992	1	37	Fusion						42.8		21	62					37		1
Marchesi, Thalgott, and Aebi, 1991	1	30	SWDL with Fusion and Instrumentation	18	12				45.8		13	71
Takahashi, Kitahara, Yamagata et al., 1990	1	39	Fusion	5	34	4	3	1	51		34	74					29	10	1.3
Knox, Harvell, Nelson et al., 1989	1	39	SWDL with Fusion and Instrumentation	15	24	15		3	64		53	80	24		3	80	20	4	1.16	3
Case-series
Booth, Bridwell, Eisenberg et al., 1999	1	49	Partial laminectomy with fusion and instrumentation	12	29	13	8	5	66.7		52	79							1.27	0
McCulloch, 1998	1	21	Partial laminectomy and fusion	6	15	2	1	1	65		51	79					14	7	1.33
Epstein, 1998b	1	28	SWDL with Fusion and Instrumentation	15	13				64		38	82					0	28	4
Mochida, Toh, Suzuki et al., 1997	1	10	Partial laminectomy with fusion and instrumentation	4	6				56.5	6.8	48	66					10	0	1
Epstein, 1998a	1	290	Mixed Decompression Techniques	94	196				67		38	82							3.2
Grob, Humke, and Dvorak, 1996	1	18	SWDL with Fusion and Instrumentation	5	13	2	1	1	54		35	77			24	60	18	0	1
Herron and Trippi, 1989	1	24	Standard Wide Decompressive Laminectomy	5	19				67		52	87	15		3	72	14	10	1.46	1
Chang and McAfee, 1989	1	17	SWDL with Fusion and Instrumentation	5	12				59.4		44	73
Inoue, Watanabe, Goto et al., 1988	1	36	Fusion	6	30				48.1		34	60
Simmons and Capicotto, 1988	1	15	SWDL with Fusion and Instrumentation						64		56	70
Hanley, 1986	1	20	SWDL with Fusion and Instrumentation	2	18				58.2		39	75					20		1	0
Kaneda and Kazama, 1986	1	54	SWDL with Fusion and Instrumentation	21	33				53		40	75					29	25	1.5
Alexander Jr, Kelly Jr, Davis Jr et al., 1985	1	50	Standard Wide Decompressive Laminectomy	12	38	9	1	3	66		47	87					49	1	1.04	8
Dall and Rowe, 1985	1	26	SWDL-Standard Wide Decompressive Laminectomy	4	13	9	4	5	60.5		47	73			1	300	12	5	1.4	4
Epstein, Epstein, Carras et al., 1983	1	60	Mixed Decompression Techniques	20	40				65		44	90	48		2	600	20	40		4
Richardson and Brown, 1980	1	21	SWDL with Fusion Arthrodesis	18	3	0
Cauchoix, Benoist, and Chassaing, 1976	1	26	SWDL-Standard Wide Decompressive Laminectomy	8	18						50	84					7	19	1.96
Epstein, Epstein, Lavine et al., 1976	1	20	Mixed Decompression Techniques	3	17	5					45	84			18	240
Trials Examining Surgical Patients with Lumbar Stenosis and/or Degenerative Spondylolisthesis
Controlled Trial
Rompe, Eysel, Zollner et al., 1999	1	39	Partial laminectomy or hemilaminectomy - patients with central lumbar stenosis	19	20	14			63	8.1			21	6.6					1.5	0
	2	51	SWDL-Standard Wide Decompressive Laminectomy - patients with central lumbar stenosis	27	24	25			59	7.9			20	5					1.5	0
	3	27	SWDL with Fusion and Instrumentation - patients with degenerative spondylolisthesis	14	13	6			64	8.8			30	6					1.6	0
Katz, Lipson, Lew et al., 1997	1	194	Standard Wide Decompressive Laminectomy	91	103				70	8.1			30	28					2.6	0
	2	37	SWDL with Fusion Arthrodesis	10	27				64	9.2			27	30					2	0
	3	41	SWDL with Fusion and Instrumentation	9	32				66	8.7			33	29					1.8	0
Sato and Kikuchi, 1997	1	28	Laminotomy - 2 level stenosis	19	9				64				25.2				28	0	1
Sato and Kikuchi, 1997	2	53	Laminotomy - 1 level stenosis	28	25				64				25.2				53	0	1
Rompe, Eysel, Hopf et al., 1995	1	24	SWDL with Fusion and Instrumentation - patients with lumbar stenosis	13	11	0	0	0	58.9		45	79	56.4		9	180	19	5	1.7	0
	2	24	Standard Wide Decompressive Laminectomy - patients with lumbar stenosis	12	12	0	0	0	65.6		46	86	56.4		9	180	15	9	1.3	0
	3	12	SWDL with Fusion and Instrumentation - patients with lumbar stenosis and spondylolisthesis	6	6	0	0	0	65.1		50	74	56.4		9	180			2.1	0
Sanderson and Wood, 1993	1	19	Partial laminectomy or hemilaminectomy - patients with Degenerative Spondylolisthesis	5	14				72.2		65	81	96		12	192	19	0	1
Sanderson and Wood, 1993	2	12	SWDL-Standard Wide Decompressive Laminectomy - patients with lumbar spinal stenosis	8	4				72.2		65	81	96		12	192	9	3	1.3
Robertson, Grobler, Novotny et al., 1993	1	22	SWDL-Standard Wide Decompressive Laminectomy - patients with central lumbar stenosis						69.7	8.2	56	90					22		1
Robertson, Grobler, Novotny et al., 1993	2	11	SWDL-Standard Wide Decompressive Laminectomy - patients with degenerative spondylolisthesis						69.7	8.2	56	90					11		1
Postacchini, Cinotti, Perugia et al., 1993	1	26	Laminotomy - patients with congenital or degenerative stenosis, combined, or degenerative spondylolisthesis						57		43	79					12	14	1.7
Postacchini, Cinotti, Perugia et al., 1993	2	41	Standard Wide Decompressive Laminectomy - patients with central lumbar stenosis						57		43	79					19	22	1.7
Hirabayashi, Kumano, and Kuroki, 1991	1	32	SWDL with Fusion and Instrumentation - patients with degenerative spondylolisthesis						53		19	76					30	2	1.1
Hirabayashi, Kumano, and Kuroki, 1991	2	21	SWDL with Fusion and Instrumentation - patients with lumbar stenosis						53		19	76					10	11	1.8
Herkowitz and Garfin, 1989	1	58	Standard Wide Decompressive Laminectomy - patients with degenerative stenosis
Herkowitz and Garfin, 1989	2	41	Standard Wide Decompressive Laminectomy - patients with degenerative spondylolisthesis
Prospective Trial
Jonsson, Annertz, Sjoberg et al., 1997a	1	105	Partial laminectomy or hemilaminectomy - patients with Central Spinal Stenosis and Degenerative Spondylolisthesis	60	45	17	15	2	65		37	83	57		1	480	21	84	2.2
Postacchini and Conotti, 1992	1	88	Mixed Decompression Techniques - patients with Developmental, degenerative, or combined, with or without Spondylolisthesis	24	16	48			54		38	71
Retrospective Trial with Consecutive Patients
Chen, Baba, Kamitani et al., 1994	1	80	Mixed Decompression Techniques - patients with Developmental, degenerative, or combined stenosis, or degenerative or isthmic spondylolisthesis	30	18	32			65		40	75					20	28	2
Postacchini, Cinotti, Gumina et al., 1993	1	64	Mixed Decompression Techniques - patients with Developmental, degenerative, or combined, with or without spondylolisthesis	38	26
Case-series
Guigui, Barre, Benoist et al., 1999	1	28	SWDL-Standard Wide Decompressive Laminectomy	8	15	5		5	53		31	79					7	16	2.2
Trials Examining Surgical Patients and Patients Receiving Conservative Treatment
Patients with Central Lumbar Stenosis
Simotas, Dorey, Hansraj et al., 2000	1	40	Conservative - various treatments	13	27	6	1	5	72		53	87					13	27	2.1	0
Simotas, Dorey, Hansraj et al., 2000	2	9	Surgery - not described	2	7	0	0	0	67		58	80					0	9	2.6
Mariconda, Zanforlino, Celestino et al., 2000	1	20	Standard Wide Decompressive Laminectomy	8	12	0			61		41	83	42				6	14	2	0
Mariconda, Zanforlino, Celestino et al., 2000	2	17	Untreated	6	11	0			61		41	83	42				6	11	1.7	0
Johnsson, Uden, and Rosen, 1991	1	20	Conservative-not described	15	5	1	0		60	9	42	80	22	24	4	96	0	0	0	0
	2	30	Standard Wide Decompressive Laminectomy - patients with moderate stenosis						62	9	45	78	33	35	2	180				0
	3	14	Standard Wide Decompressive Laminectomy - patients with severe stenosis						69	8	55	80	26	20	4	72				0
Patients with Central or Lateral Lumbar Stenosis Unspecified
Amundsen T, Weber H, Nordal HJ et al., 2000	1	19	SWDL-Standard Wide Decompressive Laminectomy	11	8	2	2	0			21	71								0
	2	50	Conservative - various	27	23	19	9	0			16	71								0
	3	13	SWDL-Standard Wide Decompressive Laminectomy	9	4	2	2	0			21	71								0
	4	18	Conservative - various	7	11	10	1	0			21	71								0
Hurri, Slatis, Soini et al., 1998	1	57	SWDL-Standard Wide Decompressive Laminectomy			0	0	0	50	11										12
Hurri, Slatis, Soini et al., 1998	2	18	Conservative-not described			0	0	0	47	10										4
Atlas, Deyo, Keller et al., 1996	1	81	SWDL-Standard Wide Decompressive Laminectomy	24	57	9		9	67.6		30	87								0
Atlas, Deyo, Keller et al., 1996	2	67	Conservative-many	27	40	9		9	65.3		22	89								0
Atlas, Keller, Robson et al., 2000	1	67	SWDL-Standard Wide Decompressive Laminectomy	Four year followup to Atlas, Deyo, Keller et al., 1996
Atlas, Keller, Robson et al., 2000	2	52	Conservative-many	Four year followup to Atlas, Deyo, Keller et al., 1996
Swezey, 1996	1	12	Exercise/stretching and flexibility			0	0		76		61	90	96		6	276
	2	11	Physical Therapy/massage, ultrasound, heat, ice, traction			0	0		76		61	90	96		6	276
	3	13	Epidural Steroid Injections			0	0		76		61	90	96		6	276
	4	11	Standard Wide Decompressive Laminectomy	7	4	0	0		76		61	90	96		6	276
Nagler and Bodack, 1993	1	41	Conservative-various	17	24				56.4		26	82
Nagler and Bodack, 1993	2	39	Standard Wide Decompressive Laminectomy	17	22				57.4		28	78
Herno, Airaksinen, Saari et al., 1996	1	54	Conservative-not described	33	21				54	9	30	73	52	18	1	480
Herno, Airaksinen, Saari et al., 1996	Data from surgical patients used for comparison were obtained from a larger previously published study.
Patients with Degenerative Spondylolisthesis
Fitzgerald and Newman, 1976	1	29	Rigid Brace						61		43	74
Fitzgerald and Newman, 1976	2	14	Mixed Decompression Techniques						61		43	74
Rosenberg, 1976	1	11	Partial laminectomy or hemilaminectomy						61		44	89
	2	15	Standard Wide Decompressive Laminectomy						61		44	89
	3	170	Conservative-not described						61		44	89

Evidence Table 11. Patient Signs and Symptoms for Clinical Trials of Patients with Lumbar Spinal Stenosis

Randomized controlled Trials of Patients Receiving Conservative Treatments
First Author and Year of Publication	Patient Group	N	Treatment	Back Pain			Leg Pain			Back and Leg Pain			Leg Weakness			Neurogenic Claudication			Sensory Dysfunction			Relief of Pain by Flexion	Incontinence	Extent of Stenosis
First Author and Year of Publication	Patient Group	N	Treatment	Total	Bilateral	Unilateral	Total	Bilateral	Unilateral	Total	Bilateral	Unilateral	Total	Bilateral	Unilateral	Total	Bilateral	Unilateral	Total	Bilateral	Unilateral	Relief of Pain by Flexion	Incontinence	Mild	Moderate	Severe
Trials Examining Surgical Patients with Central or Lateral Lumbar Stenosis type of stenosis unspecified or includes both types of stenosis
Fukusaki, Kobayashi, Hara et al., 1998	1	16	Epidural Saline				16									16
	2	18	Epidural Anesthetics				18									18
	3	19	Epidural Anesthetics and Steroids				19									19
Eskola, Pohjolainen, Alaranta et al., 1992	1	20	Calcitonin Injections							20															20
Eskola, Pohjolainen, Alaranta et al., 1992	2	19	Calcitonin Injections							19															19
Cuckler, Bernini, Wiesel et al., 1985	1	20	Epidural Anesthetics and Steroids
Cuckler, Bernini, Wiesel et al., 1985	2	17	Epidural Anesthetics
Patients with Degenerative Spondylolisthesis
Sinaki, Lutness, Ilstrup et al., 1989	1	29	Exercise/flexion	29
Sinaki, Lutness, Ilstrup et al., 1989	2	19	Exercise/extension	19
Trials Examining Surgical Patients with Central Lumbar Stenosis
Randomized controlled Trial
Grob, Humke, and Dvorak, 1995	1	15	Partial laminectomy or hemilaminectomy
	2	15	Partial laminectomy with fusion and instrumentation for single level
	3	15	Partial laminectomy with fusion and instrumentation for multiple levels
Controlled Trials
Herno, Saari, Suomalainen et al., 1999	1	35	Mixed Decompression Techniques - no post-surgery stenosis																1			28	7
Herno, Saari, Suomalainen et al., 1999	2	57	Mixed Decompression Techniques - post-surgery stenosis																2			51	8
Herno, Partanen, Talaslahti et al., 1999	1	41	Standard Wide Decompressive Laminectomy post surgery stenosis
Herno, Partanen, Talaslahti et al., 1999	2	15	Standard Wide Decompressive Laminectomy no post surgery stenosis
Hanakita, Suwa, and MIzuno, 1999	1	59	Standard Wide Decompressive Laminectomy SWDL
	2	61	Standard Wide Decompressive Laminectomy
	3	16	Partial laminectomy or hemilaminectomy
	4	20	SWDL with Fusion Arthrodesis
Thomas, Rea, Pikul et al., 1997	1	12	Standard Wide Decompressive Laminectomy													10
Thomas, Rea, Pikul et al., 1997	2	14	Laminotomy													13
Yone, Sakou, Kawauchi et al., 1996	1	10	SWDL with Fusion and Instrumentation
Yone, Sakou, Kawauchi et al., 1996	2	17	Laminotomy
Ray, 1982	1	48	Standard Wide Decompressive Laminectomy
Ray, 1982	2	17	Partial laminectomy or hemilaminectomy
Surin, Hedelin, and Smith, 1982	1	15	Standard Wide Decompressive Laminectomy - marked stenosis													12			3					0	0	15
Surin, Hedelin, and Smith, 1982	2	7	Standard Wide Decompressive Laminectomy - moderate stenosis													2			3					0	7	0
Tajima, Fukazawa, and Ishio, 1980	1	13	Mixed Decompression Techniques	13			6						4			8			7
Tajima, Fukazawa, and Ishio, 1980	2	14	Mixed Decompression Techniques - disk lesion	11			10						11			6
Prospective Trials
Kleeman, Hiscoe, and Berg, 2000	1	54	Partial Laminectomy	46			51						37			54			32
Weiner, Wlaker, Brower et al., 1999	1	30	Partial Laminectomy													30
diPierro, Helm, Shaffrey et al., 1996	1	35	Hemilaminectomy and fusion	29				3	19				22				10	6	26
Retrospective Trial with Consecutive Patients
Vitaz, Raque, Shields et al., 1999	1	65	Mixed Decompression Techniques	58			63			43			32			44			36				3
Matsui, Kanamori, Ishihara et al., 1997	1	27	SWDL with Fusion Arthrodesis													27
Airaksinen, Herno, Turunen et al., 1997	1	497	Standard Wide Decompressive Laminectomy	4			254									101								83	218	137
Mullin, Rea, Irsik et al., 1996	1	72	Standard Wide Decompressive Laminectomy																18
Ishac, Alhayek, Fournier et al., 1996	1	34	Standard Wide Decompressive Laminectomy	10			34									16
Jonsson and Stromqvist, 1994	1	43	Partial laminectomy or hemilaminectomy
Caputy and Luessenhop, 1992	1	100	Standard Wide Decompressive Laminectomy													47
Dhar and Porter, 1992	1	36	Standard Wide Decompressive Laminectomy
Chahal, Mundkur, Sancheti et al., 1982	1	32	Standard Wide Decompressive Laminectomy	32							12	13	5			14			12				2	7	20	4
Rosomoff, 1981	1	50	Standard Wide Decompressive Laminectomy	3			5		30		12		27								28		13	2	32	16
Getty, 1980	1	35	Standard Wide Decompressive Laminectomy	2					1		18	10			3	12			18				2
Reale, Deifini, Gambacona et al., 1978	1	37	Standard Wide Decompressive Laminectomy - congenital stenosis										17						18				7
Verbiest, 1977	1	116	Standard Wide Decompressive Laminectomy - congenital stenosis	82												87
Case-series
Young, Veerapen, and O'Laoire, 1988	1	32	Decompressive Surgery	23				18	14				11			23			18
Kurihara, Tanaka, Tsumura et al., 1988	1	12	Standard Wide Decompressive Laminectomy - hyperostotic stenosis				5						12			7			12
Hall, Bartleson, Onofrio et al., 1985	1	68	Standard Wide Decompressive Laminectomy	44			63						29			64			43			56
Weinstein, Scafuri, and McNeill, 1983	1	24	Standard Wide Decompressive Laminectomy							24
Weir and De Leo, 1981	1	81	Standard Wide Decompressive Laminectomy													12										12
Johnsson, Willner, and Pettersson, 1981	1	27	Standard Wide Decompressive Laminectomy	27			27			10						22								5	15	7
Verbiest, 1979	1	11	SWDL with Fusion Arthrodesis - congenital lumbar stenosis	10			8						8			8			5							11
Salibi, 1976	1	19	Standard wide laminectomy 16 patients and unilateral laminectomy 3 patients													18										17
Trials Examining Surgical Patients with Lateral Lumbar Stenosis
Randomized controlled Trial
Lee and deBari, 1986	1	12	SWDL with Fusion Arthrodesis
Lee and deBari, 1986	2	12	SWDL with Fusion and Instrumentation
Controlled Trials
Kirkaldy-Willis, Wedge, Yong-Hing et al., 1982	1	20	Partial laminectomy or hemilaminectomy				20						7						5
	2	32	Partial laminectomy or hemilaminectomy - with disk herniation				32						12						17				4
	3	21	Partial laminectomy or hemilaminectomy - Lateral and Central Stenosis				21						11						12
	4	21	Partial laminectomy or hemilaminectomy - Lateral and Central Stenosis and disk herniation				21						10						8				1
Mikhael, Ciric, Tarkington et al., 1981	1	35	Standard Wide Decompressive Laminectomy					18	17				21			35			4			35	4
	2	50	Control/Placebo/None
Retrospective Trial with Consecutive Patients
Sanderson and Getty, 1996	1	66	Laminotomy				57						6			5			19
Baba, Uchida, Maezawa et al., 1996	1	31	Laminotomy	26			20						16			17			17
Aryanpur and Ducker, 1990	1	32	Laminotomy
Case-series
Choudhury and Taylor, 1977	1	28	Standard Wide Decompressive Laminectomy	28			28	2	22				13						21				3
Epstein, Epstein, Rosenthal et al., 1972	1	15	Foraminotomy/nerve root decompression	9			15	3	12				8						6
Trials Examining Surgical Patients with Centralor Lateral Lumbar Stenosis type of stenosis unspecified or includes bothtypes of stenosis
Controlled Trial
Yone and Sakou, 1999	1	14	Laminotomy - patients with instability
	2	19	Laminotomy with Fusion and Instrumentation - patients with instability
	3	27	Laminotomy - patients without instability
Epstein, 1999	1	10	Standard Wide Decompressive Laminectomy - patients with Ossification of the Posterior Longitudinal Ligament
Epstein, 1999	2	11	Standard Wide Decompressive Laminectomy - patients with Ossification of the Yellow Ligament
Javid and Hadar, 1998	1	86	Standard Wide Decompressive Laminectomy - patients with central stenosis	83			84						31			65			44
	2	61	Standard Wide Decompressive Laminectomy - patients with central stenosis and herniated disks	61			60						25			35			33
	3	23	Standard Wide Decompressive Laminectomy - patients with lateral stenosis	23			22						12			13			15
Kalbarczyk, Lukes, and Seiler, 1998	1	93	Standard Wide Decompressive Laminectomy - patients without instability
	2	46	Partial laminectomy or hemilaminectomy- patients with mild instability
	3	9	Partial laminectomy and fusion - patients with high instability
Pai and Kumar, 1996	1	30	Decompressive Surgery - patients with congenital stenosis	26			18						9			24			10				0
Pai and Kumar, 1996	2	23	Decompressive Surgery - patients with degenerative stenosis	23			11						10			12			18				2
Kawauchi, Yone, and Sakou, 1996	1	7	Partial laminectomy and fusion - patients with slight adhesions																					1	5	1
	2	16	Partial laminectomy and fusion- patients with moderate adhesions																					1	7	8
	3	13	Partial laminectomy and fusion- patients with marked adhesions																					2	7	4
Cinotti, Postacchini, and Weinstein, 1994	1	25	Standard Wide Decompressive Laminectomy - patients with diabetes										11			21						21
Cinotti, Postacchini, and Weinstein, 1994	2	25	Standard Wide Decompressive Laminectomy - patients without diabetes										10			19						25
Little and MacDonald, 1994	1	60	SWDL with Fusion Arthrodesis
Little and MacDonald, 1994	2	34	SWDL with Fusion Arthrodesis
Simpson, Silveri, Balderston et al., 1993	1	33	Standard Wide Decompressive Laminectomy - patients with diabetes				21						12			33			13
Simpson, Silveri, Balderston et al., 1993	2	24	Standard Wide Decompressive Laminectomy - patients without diabetes							14			10			24			12
Jonsson and Stromqvist, 1993a	1	20	Partial laminectomy or hemilaminectomy - patients with central stenosis							20
Jonsson and Stromqvist, 1993a	2	19	Partial laminectomy or hemilaminectomy - patients with lateral stenosis							19
Nasca, 1989	1	15	Decompressive Surgery -patients with lateral lumbar stenosis
	2	29	Decompressive Surgery - patients with central or combined lumbar stenosis
	3	16	Decompressive Surgery with fusion and instrumentation - patients with central or combined lumbar stenosis
	4	21	Decompressive Surgery - patients with postsurgical stenosis
	5	22	Decompressive Surgery with fusion and instrumentation - patients with instability																				2
	6	11	Decompressive Surgery with fusion and instrumentation - patients with degenerative stenosis and scoliosis
Nather and Thomas, 1985	1	11	Decompressive surgery with or without fusion - patients with degenerative lumbar stenosis
Nather and Thomas, 1985	2	14	Decompressive surgery with or without fusion - patients with combined degenerative and congenital lumbar stenosis
Paine, 1976	1	95	Standard Wide Decompressive Laminectomy - patients with degenerative stenosis
Paine, 1976	2	48	Standard Wide Decompressive Laminectomy- patients with degenerative stenosis and disk herniation
Shenkin and Hash, 1976	1	49	Standard Wide Decompressive Laminectomy - patients with no prior surgery	7				2	10		9	21												49
	2	21	Standard Wide Decompressive Laminectomy - patients with prior surgery for herniated disk	3				1	14		1	2												21
Tile, McNeil, Zarins et al., 1976	1	26	Mixed Decompression Techniques - patients with lumbar stenosis
Tile, McNeil, Zarins et al., 1976	2	18	Standard Wide Decompressive Laminectomy - patients with congenital stenosis
Retrospective Trial with Consecutive Patients
Crock, Shiraishi, and Crock, 1995	1	34	Partial laminectomy or hemilaminectomy	34			34	28	6				21		912	23			11				4
Silvers, Lewis, and Asch, 1993	1	248	Standard Wide Decompressive Laminectomy	244			228			218			83			213			24
Katz, Lipson, Larson et al., 1991	1	88	Mixed Decompression Techniques										37			25			28			88
Ganz, 1990	1	36	Standard Wide Decompressive Laminectomy													15						23
Case-series
Norcross-Nechay, Mathew, Simmons et al., 1999	1	70	Decompressive Surgery with fusion and instrumentation	70					29							70
Guigui, Benoist, Delecourt et al., 1998	1	50	Decompressive surgery				50						39												40	10
Scholz, Firsching, and Lanksch, 1998	1	72	Decompressive Surgery							68						25			57
Tsai, Yang, and Bray, 1998	1	62	Laminotomy	49	45	4	48	23	25				10			13			18
Mackay and Wheelwright, 1998	1	50	Partial laminectomy or hemilaminectomy	50			36						16						47
Whitecloud, Castro Jr, Brinker et al., 1998	1	35	SWDL with Fusion and Instrumentation	35
Spetzger, Bertalanffy, Reinges et al., 1997	1	29	Laminotomy	26												27			15				2
Katz, Lipson, Chang et al., 1996	1	88	Standard Wide Decompressive Laminectomy
Lehto and Honkanen, 1995	1	96	Decompressive Surgery	91						71			84			75
Stucki, Liang, Fossel et al., 1995	1	203	Decompressive Surgery				69			98			111						98
Tuite, Stern, Doran et al., 1994	1	119	Standard Wide Decompressive Laminectomy	92			112						56						60				2
McCullen, Bernini, Bernstein et al., 1994	1	193	Decompressive Surgery										26						12
Simmons and Simmons, 1992	1	40	SWDL with Fusion and Instrumentation	35			34									40
Mauersberger and Nietgen, 1989	1	92	Decompressive surgery with or without fusion
Johnsson, Redlund-Johnell, Uden et al., 1989	1	61	Standard Wide Decompressive Laminectomy
Brodsky, Hendricks, Khalil et al., 1989	1	34	Fusion
Jalovaara, Lahde, Iikko et al., 1989	1	31	Standard Wide Decompressive Laminectomy	22			31									18								0	6	25
Fast, Robin, and Floman, 1985	1	19	Standard Wide Decompressive Laminectomy	19			19									14						7
Boccanera, Pellicioni, and Laus, 1984	1	25	Standard Wide Decompressive Laminectomy							23	14	9	8		71	15			13	9	4
Hood and Weigl, 1983	1	21	Standard Wide Decompressive Laminectomy	20	18	2	20	4	16				20			20
Scafuri and Weinstein, 1981	1	27	Standard Wide Decompressive Laminectomy	27			20						2			8			19				2
Echeverria and Lockwood, 1979	1	35	Standard Wide Decompressive Laminectomy
Scapinelli, 1978	1	23	Standard Wide Decompressive Laminectomy
Vestad and Naca, 1977	1	80	Standard Wide Decompressive Laminectomy
McKinley and Davis, 1976	1	32	Standard Wide Decompressive Laminectomy	28			28	10	18				17			22			18
Teng and Papatheodorou, 1963	1	29	SWDL-Standard Wide Decompressive Laminectomy	27			26						16						26
Epstein, Epstein, and Lavine, 1962	1	29	Mixed Decompression Techniques																				1
Epstein, 1960	1	14	Standard Wide Decompressive Laminectomy	14									14						11				4
Trials Examining Surgical Patients with Degenerative Spondylolisthesis
Randomized controlled Trial
Fischgrund, Mackay, Herkowitz et al., 1997	1	40	SWDL with Fusion and Instrumentation	38			40
Fischgrund, Mackay, Herkowitz et al., 1997	2	35	SWDL with Fusion Arthrodesis	33			35
Thomsen, Christensen, Eiskjaer et al., 1997	1	20	Partial laminectomy with fusion and instrumentation
Thomsen, Christensen, Eiskjaer et al., 1997	2	21	Partial laminectomy and fusion
Bridwell, Sedgewick, O'Brien et al., 1993	1	9	Partial laminectomy or hemilaminectomy													9
	2	10	Partial laminectomy and fusion													10
	3	24	Partial laminectomy with fusion and instrumentation													24
Herkowitz and Kurz, 1991	1	25	SWDL-Standard Wide Decompressive Laminectomy
Herkowitz and Kurz, 1991	2	25	SWDL with Fusion Arthrodesis
Controlled Trials
Plotz and Benini, 1998	1	17	Decompressive Surgery without fusion
	2	18	Decompressive Surgery with fusion and Translaminar Screw Fixation
	3	71	Decompressive Surgery with fusion and AO Internal Fixator
Yuan, Garfin, Dickman et al., 1994	1	2177	Fusion and Pedical Screw Fixation	2121			2125
	2	456	Fusion	449			451
Satomi, Hirabayashi, Toyama et al., 1992	1	27	Fusion and instrumentation	27			24									6							8	9	8	10
Satomi, Hirabayashi, Toyama et al., 1992	2	14	Mixed Decompression Techniques	10			14									9							3	2	3	9
Lombardi, Wiltse, Reynolds et al., 1985	1	20	SWDL-Standard Wide Decompressive Laminectomy
Lombardi, Wiltse, Reynolds et al., 1985	2	21	SWDL with Fusion Arthrodesis
Prospective Trials
Nakai, Yoshizawa, and Kobayashi, 1999	1	23	Fusion only
Rechtine, Sutterlin, Wood et al., 1996	1	18	SWDL with Fusion and Instrumentation																					11	7	0
Retrospective Trial with Consecutive Patients
Stambough, 1999	1	35	SWDL with Fusion and Instrumentation
Nishizawa and Fujimura, 1997	1	58	Fusion and instrumentation																					19	15	24
Moller, Wittenberg, Nolte et al., 1992	1	37	Fusion																					23	14	0
Marchesi, Thalgott, and Aebi, 1991	1	30	SWDL with Fusion and Instrumentation													9								9	16	4
Takahashi, Kitahara, Yamagata et al., 1990	1	39	Fusion													32
Knox, Harvell, Nelson et al., 1989	1	39	SWDL with Fusion and Instrumentation	21			22						17			22
Case-series
Booth, Bridwell, Eisenberg et al., 1999	1	49	Partial laminectomy with fusion and instrumentation													49
McCulloch, 1998	1	21	Partial laminectomy and fusion				21
Epstein, 1998b	1	28	SWDL with Fusion and Instrumentation
Mochida, Toh, Suzuki et al., 1997	1	10	Partial laminectomy with fusion and instrumentation
Epstein, 1998a	1	290	Mixed Decompression Techniques
Grob, Humke, and Dvorak, 1996	1	18	SWDL with Fusion and Instrumentation	18												5
Herron and Trippi, 1989	1	24	Standard Wide Decompressive Laminectomy				24	11	13	24			13		1	8			12	2	10
Chang and McAfee, 1989	1	17	SWDL with Fusion and Instrumentation	17
Inoue, Watanabe, Goto et al., 1988	1	36	Fusion	36			36									24			36
Simmons and Capicotto, 1988	1	15	SWDL with Fusion and Instrumentation
Hanley, 1986	1	20	SWDL with Fusion and Instrumentation	20			20
Kaneda and Kazama, 1986	1	54	SWDL with Fusion and Instrumentation	47			36						45			34			39
Alexander Jr, Kelly Jr, Davis Jr et al., 1985	1	50	Standard Wide Decompressive Laminectomy				43	15	28
Dall and Rowe, 1985	1	26	SWDL-Standard Wide Decompressive Laminectomy	15
Epstein, Epstein, Carras et al., 1983	1	60	Mixed Decompression Techniques							11					16	49			32
Richardson and Brown, 1980	1	21	SWDL with Fusion Arthrodesis
Cauchoix, Benoist, and Chassaing, 1976	1	26	SWDL-Standard Wide Decompressive Laminectomy	21			12						6			14			4				1
Epstein, Epstein, Lavine et al., 1976	1	20	Mixed Decompression Techniques	20												7			9			7	5
Trials Examining Surgical Patients with LumbarStenosis and/or Degenerative Spondylolisthesis
Controlled Trial
Rompe, Eysel, Zollner et al., 1999	1	39	Partial laminectomy or hemilaminectomy - patients with central lumbar stenosis							39			23						16
	2	51	SWDL-Standard Wide Decompressive Laminectomy - patients with central lumbar stenosis							51			24						18
	3	27	SWDL with Fusion and Instrumentation - patients with degenerative spondylolisthesis							27			11						14
Katz, Lipson, Lew et al., 1997	1	194	Standard Wide Decompressive Laminectomy										54						45
	2	37	SWDL with Fusion Arthrodesis										15						11
	3	41	SWDL with Fusion and Instrumentation										16						9
Sato and Kikuchi, 1997	1	28	Laminotomy - 2 level stenosis													28								0	0	28
Sato and Kikuchi, 1997	2	53	Laminotomy - 1 level stenosis													53								0	53	0
Rompe, Eysel, Hopf et al., 1995	1	24	SWDL with Fusion and Instrumentation - patients with lumbar stenosis	24									9			10			17						24
	2	24	Standard Wide Decompressive Laminectomy - patients with lumbar stenosis	24									15			8			6							24
	3	12	SWDL with Fusion and Instrumentation - patients with lumbar stenosis and spondylolisthesis	12									5			8			6							12
Sanderson and Wood, 1993	1	19	Partial laminectomy or hemilaminectomy - patients with Degenerative Spondylolisthesis					8	11							10									12	7
Sanderson and Wood, 1993	2	12	SWDL-Standard Wide Decompressive Laminectomy - patients with lumbar spinal stenosis					6	6							6
Robertson, Grobler, Novotny et al., 1993	1	22	SWDL-Standard Wide Decompressive Laminectomy - patients with central lumbar stenosis
Robertson, Grobler, Novotny et al., 1993	2	11	SWDL-Standard Wide Decompressive Laminectomy - patients with degenerative spondylolisthesis
Postacchini, Cinotti, Perugia et al., 1993	1	26	Laminotomy - patients with congenital or degenerative stenosis, combined, or degenerative spondylolisthesis
Postacchini, Cinotti, Perugia et al., 1993	2	41	Standard Wide Decompressive Laminectomy - patients with central lumbar stenosis
Hirabayashi, Kumano, and Kuroki, 1991	1	32	SWDL with Fusion and Instrumentation - patients with degenerative spondylolisthesis
Hirabayashi, Kumano, and Kuroki, 1991	2	21	SWDL with Fusion and Instrumentation - patients with lumbar stenosis
Herkowitz and Garfin, 1989	1	58	Standard Wide Decompressive Laminectomy - patients with degenerative stenosis
Herkowitz and Garfin, 1989	2	41	Standard Wide Decompressive Laminectomy - patients with degenerative spondylolisthesis
Prospective Trials
Jonsson, Annertz, Sjoberg et al., 1997a	1	105	Partial laminectomy or hemilaminectomy - patients with Central Spinal Stenosis and Degenerative Spondylolisthesis	91			105									69										101
Postacchini and Conotti, 1992	1	88	Mixed Decompression Techniques - patients with Developmental, degenerative, or combined, with or without Spondylolisthesis
Retrospective Trial with Consecutive Patients
Chen, Baba, Kamitani et al., 1994	1	80	Mixed Decompression Techniques - patients with Developmental, degenerative, or combined stenosis, or degenerative or isthmic spondylolisthesis																					16	26	6
Postacchini, Cinotti, Gumina et al., 1993	1	64	Mixed Decompression Techniques - patients with Developmental, degenerative, or combined, with or without spondylolisthesis
Case-series
Guigui, Barre, Benoist et al., 1999	1	28	SWDL-Standard Wide Decompressive Laminectomy
Trials Examining Surgical Patients and Patients Receiving Conservative Treatment
Patients with Central Lumbar Stenosis
Simotas, Dorey, Hansraj et al., 2000	1	40	Conservative - various treatments																					6	19	15
Simotas, Dorey, Hansraj et al., 2000	2	9	Surgery - not described																					0	2	7
Mariconda, Zanforlino, Celestino et al., 2000	1	20	Standard Wide Decompressive Laminectomy	18			17						10			18			12
Mariconda, Zanforlino, Celestino et al., 2000	2	17	Untreated	16			14						8			16			10
Johnsson, Uden, and Rosen, 1991	1	20	Conservative-not described				2									16									19	1
	2	30	Standard Wide Decompressive Laminectomy - patients with moderate stenosis				5									23									30
	3	14	Standard Wide Decompressive Laminectomy - patients with severe stenosis				2									12										14
Patients with Central or Lateral Lumbar Stenosis Unspecified
Amundsen T, Weber H, Nordal HJ et al., 2000	1	19	Standard Wide Decompressive Laminectomy				19																	2	12	5
	2	50	Conservative - various treatments				50																	8	25	17
	3	13	Standard Wide Decompressive Laminectomy				13																	4	7	2
	4	18	Conservative - various treatments				18																	6	5	7
Hurri, Slatis, Soini et al., 1998	1	57	SWDL-Standard Wide Decompressive Laminectomy	56			47												38						31	26
Hurri, Slatis, Soini et al., 1998	2	18	Conservative-not described	18			13												8						12	6
Atlas, Deyo, Keller et al., 1996	1	81	SWDL-Standard Wide Decompressive Laminectomy	62			66						18			56			12
Atlas, Deyo, Keller et al., 1996	2	67	Conservative-many	38			34						16			34			15
Swezey, 1996	1	12	Exercise/stretching and flexibility														12
	2	11	Physical Therapy/massage, ultrasound, heat, ice, traction														11
	3	13	Epidural Steroid Injections														13
	4	11	Standard Wide Decompressive Laminectomy														11								7	4
Nagler and Bodack, 1993	1	41	Conservative-various
Nagler and Bodack, 1993	2	39	Standard Wide Decompressive Laminectomy
Herno, Airaksinen, Saari et al., 1996	1	54	Conservative-not described				37									13									50	4
Herno, Airaksinen, Saari et al., 1996	Data from surgical patients used for comparison were obtained from a larger previously published study.
Patients with Degenerative Spondylolisthesis
Fitzgerald and Newman, 1976	1	29	Rigid Brace	29
Fitzgerald and Newman, 1976	2	14	Mixed Decompression Techniques	10			5									4
Rosenberg, 1976	1	11	Partial laminectomy or hemilaminectomy
	2	15	Standard Wide Decompressive Laminectomy
	3	170	Conservative-not described

Evidence Table 12. Ability to Work Outcomes from Clinical Trials of Patients with Lumbar Spinal Stenosis

Randomized Controlled Trials of Patients Receiving Conservative Treatments

Patient Condition:

Spondylolisthesis

Authors and Year:

Sinaki, Lutness, Ilstrup et al., 1989

Reporting:

Patient-reported

Method:

2 Levels. Working, or Limited or unable to work.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Number Working

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

Exercise/flexion

Degenerative Spondylolisthesis

Exercise/extension

34.8

Trials Examining Surgical Patients with Central Lumbar Stenosis

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Airaksinen, Herno, Turunen et al., 1997
Reporting:	Patient-reported
Method:	Reported before and after surgery.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Number Working

Rating Category

Mean

Min.

Max.

497

Central Lumbar Stenosis

SWDL-Standard Wide
Decompressive Laminectomy

438

121

Trials Examining Surgical Patients with Lateral Lumbar Stenosis

Study Design:	Controlled Trial
Authors and Year:	Kirkaldy-Willis, Wedge, Yong-Hing et al., 1982
Reporting:	Patient-reported
Method:	3 levels. Ex: Same, Gd: Lighter, Pr: None

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Number Working

Rating Category

Mean

Min.

Max.

Lateral Lumbar Stenosis

Partial laminectomy or hemilaminectomy

120

Lateral Lumbar Stenosis with disk herination

Partial laminectomy or hemilaminectomy

120

Lateral and Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

120

Lateral and Central Lumbar or Stenosis with disk herniation

Partial laminectomy hemilaminectomy

120

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Sanderson and Getty, 1996
Reporting:	Patient-reported
Method:	3 levels based on patients opinion on ability to work. Excellent: heavy work, Good: light work, Poor: unable to work.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Number Working

Rating Category

Mean

Min.

Max.

Lateral Lumbar Stenosis

Laminotomy

101

132

Study Design:	Case-series
Authors and Year:	Choudhury and Taylor, 1977
Reporting:	Patient-reported
Method:	3 Levels: Full Capacity, Reduced capacity, Incapacitated.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Number Working

Rating Category

Mean

Min.

Max.

Lateral Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Trials Examining Surgical Patients with Central or Lateral Lumbar Stenosis (type of stenosis unspecified or includes both types of stenosis)

Study Design:	Controlled Trial
Authors and Year:	Javid and Hadar, 1998
Reporting:	Patient-reported
Method:	Percentage of patients working who had been working prior to surgery.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Number Working

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

57.2

132

Central Lumbar Stenosis and Herniated Disk

SWDL-Standard Wide Decompressive Laminectomy

56.6

132

Lateral Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

86.6

132

Study Design:	Case-series
Authors and Year:	Vestad and Naca, 1977
Reporting:	Patient-reported
Method:	3 Levels: Incapable of working, partial capacity, full capacity.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Number Working

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

56.4

Trials Examining Surgical Patients with Degenerative Spondylolisthesis

Study Design:	Prospective Trial
Authors and Year:	Rechtine, Sutterlin, Wood et al., 1996
Reporting:	Patient-reported
Method:	Number of patients working before surgery who returned to work.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Number Working

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Knox, Harvell, Nelson et al., 1989
Reporting:	Patient-reported
Method:	Number of patients returned to work

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Number Working

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

21.3

Study Design:	Case-series
Authors and Year:	Booth, Bridwell, Eisenberg et al., 1999
Reporting:	Patient-reported
Method:	5 levels of work/school-related activity: 100%, 75%, 50%, 25%, 0%.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Number Working

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

Partial laminectomy with fusion and instrumentation

129

Authors and Year:	Grob, Humke, and Dvorak, 1996
Reporting:	Patient-reported
Method:	Number of patients eligible to work who returned to work.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Number Working

Rating Category

Mean

Min.

Max.

Degenerative/spondylolytic Spondylolisthesis

SWDL with Fusion and Instrumentation

Trials Examining Surgical Patients and Patients Receiving Conservative Treatment

Patient Condition:	Central lumbar stenosis
Study Design:	Controlled Trial
Authors and Year:	Johnsson, Uden, and Rosen, 1991
Reporting:	Patient-reported
Method:	Complete information was only available for the untreated nonsurgery group.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Number Working

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

Conservative-not described

Evidence Table 13. Back Pain Outcomes Related to Treatment of Lumbar Spinal Stenosis

Randomized Controlled Trials of Patients Receiving Conservative Treatments

Patient Condition:	Spondylolisthesis
Authors and Year:	Sinaki, Lutness, Ilstrup et al., 1989
Reporting:	Patient-reported
Method:	2 Levels: Good: None or mild pain, and Poor: Moderate or severe pain.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

Exercise/flexion

Degenerative Spondylolisthesis

Exercise/extension

34.8

Trials Examining Surgical Patients with Central Lumbar Stenosis

Study Design:	Randomized Controlled Trial
Authors and Year:	Grob, Humke, and Dvorak, 1995
Reporting:	Patient-reported
Method:	Visual analog scale of 0 to 10. Values are not reported separately for back and leg but as a combined Pain score.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

7.8

1.8

Central Lumbar Stenosis - single level

Partial laminectomy with fusion and instrumentation

7.8

Central Lumbar Stenosis - multiple segments

Partial laminectomy with fusion and instrumentation

8.8

Study Design:	Controlled Trial
Authors and Year:	Hanakita, Suwa, and MIzuno, 1999
Reporting:	Patient-reported
Method:	3 levels. Gd: Improved, Fr: Unchanged, Pr: Worse.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis - younger than 64 years

SWDL-Standard Wide Decompressive Laminectomy

Central Lumbar Stenosis - older than 64 years

SWDL-Standard Wide Decompressive Laminectomy

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

Central Lumbar Stenosis

SWDL with Fusion (Arthrodesis)

Study Design:	Prospective Trial
Authors and Year:	diPierro, Helm, Shaffrey et al., 1996
Reporting:	Patient-reported
Method:	Score from 0 (no pain) - 10 (severe pain). Also reported number of patients with no pain at followup.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

Partial laminectomy and fusion

9.2

3.31

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Vitaz, Raque, Shields et al., 1999
Reporting:	Patient-reported
Method:	3 levels. No change, Improved, and Resolved

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

Mixed Decompression Techniques

19.6

Authors and Year:	Matsui, Kanamori, Ishihara et al., 1997
Reporting:	Patient-reported
Method:	Japanese Orthopaedic Association evaluation system. Scored from 0 (frequent severe pain) to 3 (no pain)

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL with Fusion (Arthrodesis)

1.4

0.5

2.5

0.6

Study Design:	Case-series
Authors and Year:	Johnsson, Willner, and Pettersson, 1981
Reporting:	Patient-reported
Method:	Number of patients with back and leg pain

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Trials Examining Surgical Patients with LateralLumbar Stenosis

Study Design:	Case-series
Authors and Year:	Choudhury and Taylor, 1977
Reporting:	Patient-reported
Method:	3 Levels: Absent, Mild (Occasional), Recurring

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Lateral Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Trials Examining Surgical Patients with Central or Lateral Lumbar Stenosis (type of stenosis unspecified or includes both types of stenosis)

Study Design:	Controlled Trial
Authors and Year:	Yone and Sakou, 1999
Reporting:	Physician-reported
Method:	JOA score

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Mixed Stenosis with instability

Laminotomy

1.4

1.7

Mixed Stenosis with instability

Laminotomy with Fusion and Instrumentation

1.4

2.6

Mixed Stenosis without instability

Laminotomy

1.3

2.7

Authors and Year:	Javid and Hadar, 1998
Reporting:	Patient-reported
Method:	5 levels. Ex: None, Gd: Rarely, Fr: Sometimes, Pr: most times, VPr: constant

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

57.2

132

Central Lumbar Stenosis and Herniated Disk

SWDL-Standard Wide Decompressive Laminectomy

56.6

132

Lateral Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

86.6

132

Authors and Year:	Kawauchi, Yone, and Sakou, 1996
Reporting:	Patient-reported
Method:	Japanese Orthopedic Association for low back pain score (JOA score)

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Mixed Stenosis - slight adhesion

Partial laminectomy and fusion

14.1

2.6

Mixed Stenosis - moderate adhesion

Partial laminectomy and fusion

11.4

5.5

Mixed Stenosis - marked adhesion

Partial laminectomy and fusion

12.8

4.8

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Katz, Lipson, Larson et al., 1991
Reporting:	Patient-reported
Method:	6 levels. 1: Very Severe, 2: Severe, 3: Moderate, 4: Mild, 5: Very Mild, 6: None

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Mixed Stenosis

Mixed Decompression Techniques

Study Design:	Case-series
Authors and Year:	Mackay and Wheelwright, 1998
Reporting:	Patient-reported
Method:	Yes or no, pre and post

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Mixed Stenosis

Partial laminectomy or hemilaminectomy

Authors and Year:	Tsai, Yang, and Bray, 1998
Reporting:	Patient-reported
Method:	Analog scale 0-20

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Mixed Stenosis

Laminotomy

14.4

5.8

4.9

6.5

Authors and Year:	Whitecloud, Castro, Brinker et al., 1998
Reporting:	Patient-reported
Method:	Analog Scale, 0-10

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Mixed Stenosis

SWDL with Fusion and Instrumentation

7.2

1.5

5.5

2.6

Authors and Year:	Katz, Lipson, Chang et al., 1996
Reporting:	Patient-reported
Method:	3 Levels: Severe or very severe, Moderate or mild, Very Mild or none.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Stenosis

SWDL-Standard Wide Decompressive Laminectomy

120

Authors and Year:	McCullen, Bernini, Bernstein et al., 1994
Reporting:	Patient-reported
Method:	5 levels: Patient has Back and leg pain Never, occasionally, frequently, very frequently, Constantly.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

193

Mixed Stenosis

Decompressive Surgery

118

142

Authors and Year:	Simmons and Simmons, 1992
Reporting:	Patient-reported
Method:	4 levels. None, Mild (minimal disruption of lifestyle), Moderate (significant disruption of lifestyle, Severe (constant pain and problems

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Mixed Stenosis

SWDL with Fusion and Instrumentation

Trials Examining Surgical Patients with Degenerative Spondylolisthesis

Study Design:	Randomized Controlled Trial
Authors and Year:	Fischgrund, Mackay, Herkowitz et al., 1997
Reporting:	Patient-reported
Method:	Visual analog scale from 0 (no pain) to 5 (severe pain).

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

Degenerative Spondylolisthesis

SWDL with Fusion (Arthrodesis)

Authors and Year:	Herkowitz and Kurz, 1991
Reporting:	Patient-reported
Method:	Scale of no pain (0) to severe pain (5).

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

2.9

2.5

Degenerative Spondylolisthesis

SWDL with Fusion (Arthrodesis)

3.3

1.3

Study Design:	Controlled Trial
Authors and Year:	Satomi, Hirabayashi, Toyama et al., 1992
Reporting:	Patient-reported
Method:	JOA score 0 (severe pain)-3 (no pain)

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

Fusion and instrumentation

1.2

2.3

Degenerative Spondylolisthesis

Mixed Decompression Techniques

1.9

2.8

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Stambough, 1999
Reporting:	Patient-reported
Method:	Visual analog scale of 0 (no pain) to 10 (severe pain)

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

45.2

105

Authors and Year:	Nishizawa and Fujimura, 1997
Reporting:
Method:	JOA score: 0 (severe pain) to 3 (no pain)

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

Fusion and instrumentation

1.1

128

2.7

Authors and Year:	Knox, Harvell, Nelson et al., 1989
Reporting:	Patient-reported
Method:	Scale of 0 (none) to 10 (severe)

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

7.4

21.3

3.2

Study Design:	Case-series
Authors and Year:	Booth, Bridwell, Eisenberg et al., 1999
Reporting:	Patient-reported
Method:	Analog Scale, 0-9. 5 levels of experience back or leg pain: Never, Rarely, Sometimes, Often, Very Often.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

Partial laminectomy with fusion and instrumentation

7.35

2.36

3.32

2.25

129

3.25

3.32

Authors and Year:	Grob, Humke, and Dvorak, 1996
Reporting:	Patient-reported
Method:	VAS 0-10 scale

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative/spondylolytic Spondylolisthesis

SWDL with Fusion and Instrumentation

7.6

1.5

Authors and Year:	Inoue, Watanabe, Goto et al., 1988
Reporting:
Method:	4-level score on JOA scale

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

Fusion

127

324

2.7

Authors and Year:	Dall and Rowe, 1985
Reporting:	Patient-reported
Method:	2 levels: Yes or No, pre- and post.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

Trials Examining Surgical Patients with Lumbar Stenosis and/or Degenerative Spondylolisthesis

Study Design:	Controlled Trial
Authors and Year:	Rompe, Eysel, Zollner et al., 1999
Reporting:	Patient-reported
Method:	Pain severity from 1 (no pain) to 5 (very severe). Also the Turner Score- Good to Excellent: back and leg pain absent, minimal.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

3.8

0.7

88.8

2.5

0.8

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

3.5

0.8

2.7

0.7

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

3.6

0.8

88.8

2.4

0.9

Authors and Year:	Sato and Kikuchi et al., 1997
Reporting:	Patient-reported
Method:	pretreatment-op JOA Score (extrapolate from graph)

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Spondylosis and Degenerative Spondylolisthesis

Laminotomy - 2 level stenosis

3.6

0.9

2.6

2.7

55.2

21.6

Spondylosis and Degenerative Spondylolisthesis

Laminotomy - 1 level stenosis

0.7

2.1

2.3

55.2

Authors and Year:	Rompe, Eysel, Hopf et al., 1995
Reporting:	Patient-reported
Method:	Pain rating 0-4

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Mixed Stenosis

SWDL with Fusion and Instrumentation

2.83

21.6

1.2

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

3.1

25.9

0.7

Mixed Stenosis and Spondylolisthesis

SWDL with Fusion and Instrumentation

2.9

25.9

Study Design:	Prospective Trial
Authors and Year:	Jonsson, Annertz, Sjoberg et al., 1997a
Reporting:	Patient-reported
Method:	Number of patients with back pain

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

105

Central Spinal Stenosis and Degenerative Spondylolisthesis

Partial laminectomy or hemilaminectomy

Trials Examining Surgical Patients and Patients Receiving Conservative Treatment

Study Design:	Controlled Trial
Authors and Year:	Simotas, Dorey, Hansraj, et al., 2000
Reporting:	Patient-reported
Method:	3 levels. Good: None or mild pain, Fair: Moderate pain, Poor: Very severe or severe pain

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

Conservative-various treatments

Central Lumbar Stenosis

Surgery - not described

Authors and Year:	Mariconda, Zanforlino, Celestino et al., 2000
Reporting:	Patient-reported
Method:	0, 1, 2, 3 scale: 0- continuous severe pain, 1- occasional severe pain, 2- occasional mild pain, 3- none

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

1.1

1.5

1.3

Central Lumbar Stenosis

Control/Placebo/None

1.2

1.1

1.6

1.1

Authors and Year:	Johnsson, Uden, and Rosen, 1991
Reporting:	Patient-reported
Method:	3 levels passed on a 0-100 visual analog scale. Good: 0-37.5, Fair: 37.6-62.5, Poor: 62.6-100. These groups were considered Mild,

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

Conservative-not described

Central Lumbar Stenosis - moderate stenosis

SWDL-Standard Wide Decompressive Laminectomy

109

Central Lumbar Stenosis - severe stenosis

SWDL-Standard Wide Decompressive Laminectomy

120

Evidence Table 14. Back Pain Relief Outcomes Related to Treatment of Lumbar Spinal Stenosis

Trials Examining Surgical Patients with Central Lumbar Stenosis

Study Design:	Randomized Controlled Trial
Authors and Year:	Grob, Humke, and Dvorak, 1995
Reporting:	Patient-reported
Method:	Based on increase or decrease in pain postsurgery and on difference in VAS score.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

Central Lumbar Stenosis - single level

Partial laminectomy with fusion and instrumentation

5.8

Central Lumbar Stenosis - multiple segments

Partial laminectomy with fusion and instrumentation

5.8

Study Design:	Prospective Trial
Authors and Year:	Kleeman, Hiscoe, and Berg, 2000
Reporting:	Patient-reported
Method:	4 levels: Resolved, Better, Same, Worse

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Ishac, Alhayek, Fournier et al., 1996
Reporting:	Physician-reported
Method:	Reported relief of symptoms

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

0.2

Study Design:	Case-series
Authors and Year:	Verbiest, 1979
Reporting:	Patient-reported
Method:	2 Levels: Cured or Residual Symptoms

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Congenital Lumbar Stenosis

SWDL with Fusion (Arthrodesis)

123

204

Trials Examining Surgical Patients with Lateral Lumbar Stenosis

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Baba, Uchida, Maezawa et al., 1996
Reporting:	Physician-reported
Method:	Reported number of patients with back pain before and after surgery.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Lateral Lumbar Stenosis

Laminotomy

Trials Examining Surgical Patients with Centralor Lateral Lumbar Stenosis (type of stenosis unspecified or includes both types of stenosis)

Study Design:	Controlled Trial
Authors and Year:	Yone and Sakou, 1999
Reporting:	Physician-reported
Method:	Percent change in JOA score

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis with instability

Laminotomy

Mixed Stenosis with instability

Laminotomy with Fusion and Instrumentation

Mixed Stenosis without instability

Laminotomy

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Silvers, Lewis, and Asch, 1993
Reporting:	Patient-reported
Method:	4 levels: Excellent, Good, Fair, Poor. Excellent and Good were combined as a successful outcome.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

248

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

244

8.4

227

128

56.4

174

Authors and Year:	Ganz, 1990
Reporting:	Physician-reported
Method:	4 levels. 0- No improvement, 1-Some improvement, 2-Almost normal, 3-No symptoms

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

0.93

Study Design:	Case-series
Authors and Year:	Norcross-Nechay, Mathew, Simmons et al., 1999
Reporting:	Patient-reported
Method:	Number of patients reporting complete pain relief

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

Decompressive Surgery with fusion and instrumentation

11.8

Authors and Year:	Spetzger, Bertalanffy, Reinges et al., 1997
Reporting:	Patient-reported
Method:	3 Levels: No pain, Improved pain, Unimproved pain.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

Laminotomy

Authors and Year:	McCullen, Bernini, Bernstein et al., 1994
Reporting:	Patient-reported
Method:	5 Levels: Is the back and/or leg pain Gone, Much better, Better, Worse, Much Worse?

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

193

Mixed Stenosis

Decompressive Surgery

118

142

Authors and Year:	Fast, Robin, and Floman, 1985
Reporting:	Physician-reported
Method:	Stated that back pain was milder after surgery.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Hood and Weigl, 1983
Reporting:	Patient-reported
Method:	2 levels: complete or partial relief

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Trials Examining Surgical Patients with Degenerative Spondylolisthesis

Study Design:	Controlled Trial
Authors and Year:	Plotz and Benini, 1998
Reporting:	Patient-reported
Method:	3 Levels: Improved, Unchanged, Worse.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

Decompressive Surgery without fusion

120

Degenerative Spondylolisthesis

Decompressive Surgery with fusion and Translaminar Screw Fixation

100

Degenerative Spondylolisthesis

Decompressive Surgery with fusion and AO Internal Fixator

100

Authors and Year:	Yuan, Garfin, Dickman et al., 1994
Reporting:	Physician-reported
Method:	3 levels. Improved, No change, Worse

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

2177

Degenerative Spondylolisthesis

Fusion and Pedical Screw Fixation

2121

1941

165

456

Degenerative Spondylolisthesis

Fusion

449

391

Study Design:	Prospective Trial
Authors and Year:	Rechtine, Sutterlin, Wood et al., 1996
Reporting:	Patient-reported
Method:	5-point scale used to determine improvement. Severe, Moderate-to-severe, Moderate, Mild, None.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

Study Design:	Case-series
Authors and Year:	Herron and Trippi, 1989
Reporting:	Patient-reported
Method:	Average % relief, number of patients with complete relief.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Alexander Jr, Kelly Jr, Davis Jr et al., 1985
Reporting:	Patient-reported
Method:	3 Levels: Pain Free = Excellent, Much Less Pain = Good, No Improvement = Poor

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

131

Trials Examining Surgical Patients with Lumbar Stenosis and/or Degenerative Spondylolisthesis

Study Design:	Controlled Trial
Authors and Year:	Rompe, Eysel, Zollner et al., 1999
Reporting:	Patient-reported
Method:	Patients were asked to estimate the percentage decrease in pain.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

88.8

36.8

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

40.7

34.2

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

88.8

46.2

Authors and Year:	Postacchini, Cinotti, Perugia et al., 1993
Reporting:	Patient-reported
Method:	Improvement based on a 0-100 scale with 0 meaning greatest disability.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Congenital or Degenerative Stenosis, Combined, or Deg. Spondylolisthesis

Laminotomy

44.4

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

44.4

Trials Examining Surgical Patients and Patients Receiving Conservative Treatment

Study Design:	Controlled Trial
Authors and Year:	Atlas, Deyo, Keller et al., 1996
Reporting:	Patient-reported
Method:	3 levels. Gd: Better, Fr: Same, Pr: Worse.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Mixed Stenosis

Conservative-many

Authors and Year:	Atlas, Keller, Robson, et al. 2000
Reporting:
Method:	See Atlas, Deyo, Keller, et al. 1996

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Mixed Stenosis

Conservative-not described

Evidence Table 15. Disability and Dependency Outcomes Related to Treatment of Lumbar Spinal Stenosis

Trials Examining Surgical Patients with Central Lumbar Stenosis

Study Design:	Controlled Trial
Authors and Year:	Herno, Partanen, Talaslahti et al., 1999
Reporting:	Patient-reported
Method:	Oswestry questionnaire for low back pain disability.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis - post surgery stenosis

SWDL-Standard Wide Decompressive Laminectomy

133

113

157

31.2

Central Lumbar Stenosis - no post surgery stenosis

SWDL-Standard Wide Decompressive Laminectomy

122

113

157

28.7

Authors and Year:	Herno, Saari, Suomalainen et al., 1999
Reporting:	Patient-reported
Method:	Oswestry disability questionnaire

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis - no postsurgery stenosis

Mixed Decompression Techniques

28.4

Central Lumbar Stenosis - post surgery stenosis

Mixed Decompression Techniques

26.4

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Airaksinen, Herno, Turunen et al., 1997
Reporting:	Patient-reported
Method:	2 levels and mean. Based on an Oswestry Low Back Pain Disability Score. 0-40 was good to excellent and 41-100 was poor to very

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

497

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

438

273

165

Trials Examining Surgical Patients with Central or Lateral Lumbar Stenosis (type of stenosis unspecified or includes both types of stenosis)

Study Design:	Controlled Trial
Authors and Year:	Little and MacDonald, 1994
Reporting:	Patient-reported
Method:	Oswestry Low Back Pain Questionnaire was used to calculate a percentage change in the disability index.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

SWDL with Fusion (Arthrodesis)

32.7

51.4

37.7

42.9

Lateral Lumbar Stenosis

SWDL with Fusion (Arthrodesis)

38.8

39.8

32.6

37.5

Trials Examining Surgical Patients with Degenerative Spondylolisthesis

Study Design:	Case-series
Authors and Year:	Booth, Bridwell, Eisenberg et al., 1999
Reporting:	Patient-reported
Method:	3 Levels: Limited a lot, Limited a little, not limited.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

Partial laminectomy with fusion and instrumentation

129

Trials Examining Surgical Patients and Patients Receiving Conservative Treatment

Study Design:	Controlled Trial
Authors and Year:	Hurri, Slatis, Soini et al., 1998
Reporting:	Patient-reported
Method:	Oswestry Questionnaire for disability due to low-back pain (0-100).

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

144

34.1

Mixed Stenosis

Conservative-not described

144

28.9

Authors and Year:	Atlas, Deyo, Keller et al., 1996
Reporting:	Patient-reported
Method:	Score based on the Roland score for back disability. Lower score mean less disability.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

7.6

Mixed Stenosis

Conservative-many

10.4

Authors and Year:	Atlas, Keller, Robson, et al. 2000
Reporting:	Patient-reported
Method:	See Atlas, Deyo, Keller, et al. 1996

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

8.1

Mixed Stenosis

Conservative-not described

9.6

Authors and Year:	Herno, Airaksinen, Saari et al., 1996
Reporting:	Patient-reported
Method:	Oswestry score for back pain related disability

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

Conservative-not described

37.8

Evidence Table 16. Global Success Outcomes Related to Treatment of Lumbar Spinal Stenosis

Randomized Controlled Trials of Patient Receiving Conservative Treatments

Authors and Year:	Sinaki, Lutness, Ilstrup et al., 1989
Reporting:	Patient-reported
Method:	2 Levels. "Recovered" based on only rare episodes of mild pain, able to perform job and leisure activities w/o restriction, no need for back support.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

Exercise/flexion

Degenerative Spondylolisthesis

Exercise/extension

34.8

Trials Examining Surgical Patients with Central Lumbar Stenosis

Study Design:	Randomized Controlled Trial

Authors and Year:	Grob, Humke, and Dvorak, 1995
Reporting:	Patient-reported
Method:	4 levels: Very good = 75% relief, no analgesics or restrictions; Good = 50-74% relief, some analgesics & restrictions; Fair = <50% relief; Poor = pain worse than before surgery.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

Central Lumbar Stenosis - single level

Partial laminectomy with fusion and instrumentation

Central Lumbar Stenosis - multiple segments

Partial laminectomy with fusion and instrumentation

Study Design:	Controlled Trial

Authors and Year:	Hanakita, Suwa, and MIzuno, 1999
Reporting:	Patient-reported
Method:	4 levels. Ex: Cured, Gd: Better, Fr: Unchanged, Pr: Worse plus no comment

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis - younger than 64 years

SWDL-Standard Wide Decompressive Laminectomy

Central Lumbar Stenosis - older than 64 years

SWDL-Standard Wide Decompressive Laminectomy

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

Central Lumbar Stenosis

SWDL with Fusion (Arthrodesis)

Authors and Year:	Herno, Partanen, Talaslahti et al., 1999
Reporting:	Patient-reported
Method:	2 levels. Patients were asked whether their condition during the past 5 years had remained the same or improve (no-change group) or had worsened (final-change group).

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis - post surgery stenosis

SWDL-Standard Wide Decompressive Laminectomy

133

113

157

Central Lumbar Stenosis - no post surgery stenosis

SWDL-Standard Wide Decompressive Laminectomy

122

113

157

Authors and Year:	Ray, 1982
Reporting:	Physician-reported
Method:	4 levels: Nil, Minimum, Moderate, Excellent base on questionnaire addressing daily pain intensity, percentage of time in pain, activity level, and behavioral factors.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

10.1

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

12.6

Authors and Year:	Surin, Hedelin, and Smith, 1982
Reporting:	Physician-reported
Method:	3 levels. Ex: symptom-free, resumed all previous activities; Gd: resumed normal activities, recurrent back or leg pain; Fair and Poor combined: reduced previous activities due to pain, frankly disabled and pain not reduced.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis - marked stenosis

SWDL-Standard Wide Decompressive Laminectomy

Central Lumbar Stenosis - moderate stenosis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Tajima, Fukazawa, and Ishio, 1980
Reporting:	Physician-reported
Method:	3 levels. Good: symptoms disappeared, no restrictions for daily life and work, Fair: occasional low back pain, no inconveniences in daily life, Poor: not improved or slightly aggravated.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

Mixed Decompression Techniques

Central Lumbar Stenosis and disk lesion

Mixed Decompression Techniques

Study Design:	Prospective Trial

Authors and Year:	Kleeman, Hiscoe, and Berg, 2000
Reporting:	Patient-reported
Method:	4 levels: Very satisfied, somewhat satisfied, somewhat dissatisfied, very dissatisfied

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

Authors and Year:	Weiner, Walker, Brower et al., 1999
Reporting:	Patient-reported
Method:	Neurogenic Claudication Outcome Score (max = 100 asymptomatic with full function. 5 level surgical success scale: Ex: complete relief, Gd: a good deal of relief, Fr: only a little relief, Pr: no relief, VPr: worse

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

Authors and Year:	diPierro, Helm, Shaffrey et al., 1996
Reporting:	Patient-reported
Method:	Patient satisfied or not satisfied with surgery

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

Partial laminectomy and fusion

Study Design:	Retrospective Trial with Consecutive Patients

Authors and Year:	Matsui, Kanamori, Ishihara et al., 1997
Reporting:	Patient-reported
Method:	Japanese Orthopaedic Association evaluation system. Scored from 0-29. % recovery rate of pre- and post-op scores determined Excellent (>75&), Good (50-75), Fair (25-50), Poor (<25).

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL with Fusion (Arthrodesis)

3.9

19.3

23.2

23.8

Authors and Year:	Ishac, Alhayek, Fournier et al., 1996
Reporting:	Physician-reported
Method:	3 levels. Good (Ex): no symptoms and resumption of former activities, Acceptable (Gd) alleviation of symptoms, normal daily activities, Poor (Pr): no change, worsening of symptoms

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Mullin, Rea, Irsik et al., 1996
Reporting:	Patient-reported
Method:	5 level functional rating. V Pr: bedridden, Pr: self-care with aid, Fr: self-care alone, Gd: most desired activities, Ex: all desired activities.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Caputy and Luessenhop, 1992
Reporting:	Patient-reported
Method:	Patient rated success or failure of surgery

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

100

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Dhar and Porter, 1992
Reporting:	Patient-reported
Method:	4 levels. Ex: No pain or functional limitation, Gd: Intermittent pain, no functional limitation, Fr: Intermittent pain affecting function, Pr: Constant pain.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Chahal, Mundkur, Sancheti et al., 1982
Reporting:	Physician-reported
Method:	3 levels. Good, Fair, and Poor undefined.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Rosomoff, 1981
Reporting:	Physician-reported
Method:	3 levels. Good to Excellent: pain-free or full activity with some pain, Fair: moderately restricted, Poor and Very Poor: severely restricted to totally disabled.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

120

Authors and Year:	Getty, 1980
Reporting:	Physician-reported
Method:	3 levels. Good: pain relieved, Fair: partial pain relief with recurrence after heavy work, Poor: no relief or pain increased

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

120

Authors and Year:	Reale, Deifini, Gambacona et al., 1978
Reporting:	Patient-reported
Method:	3 levels/ Ex: patients goes back to work and is free or nearly free from pain, Gd: patient has gone back to work but has to rest now and again, Pr: all other conditions even if patient has improved.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Congenital Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Verbiest, 1977
Reporting:	Physician-reported
Method:	2 levels. Complete relief of symptoms and signs v. permanent residual or new symptoms.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

116

Congenital Stenosis

SWDL-Standard Wide Decompressive Laminectomy

240

Study Design:	Case-series

Authors and Year:	Kurihara, Tanaka, Tsumura et al., 1988
Reporting:	Physician-reported
Method:	2 Levels. Satisfactory or unsatisfactory, also described as good or fair. Not defined.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Hyperostotic stenosis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Young, Veerapen, and O'Laoire, 1988
Reporting:	Physician-reported
Method:	4 Levels: Good, Fair, Marginal, Poor

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

Decompressive Surgery

39.8

Authors and Year:	Hall, Bartleson, Onofrio et al., 1985
Reporting:	Physician-reported
Method:	3 levels: Very good to excellent, Lesser degrees of satisfaction, little or no use.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Weinstein, Scafuri, and McNeill, 1983
Reporting:	Physician-reported
Method:	4 levels. Back Analysis Form sections converted to a numerical ranking for Excellent (85-100), Good (71-84), Fair (60-70), Poor (0-60)

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

78.2

Authors and Year:	Johnsson, Willner, and Pettersson, 1981
Reporting:	Physician-reported
Method:	4 levels. Ex: no symptoms, Gd: slight residual pain, Unchanged (Fr): no relief of symptoms, Worse (Pr): increased pain. Also Improved and No Change/Worse. Individual data is presented for walking.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Weir and De Leo, 1981
Reporting:	Physician-reported
Method:	4 levels. Cured, Better, Unchanged, Worse

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

144

Authors and Year:	Salibi, 1976
Reporting:	Physician-reported
Method:	3 Levels: Good: Full return to premorbid activities; Fair: partial return; Poor: Became more comfortable, but not rehabilitated. No followup time period is reported.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Trials Examining Surgical Patients with Lateral Lumbar Stenosis

Study Design:	Randomized Controlled Trial

Authors and Year:	Lee and deBari, 1986
Reporting:	Patient-reported
Method:	Scoring system from 0-100 to evaluate patient pain and degree of tolerable activities of daily living.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Lateral Lumbar Stenosis

SWDL with Fusion (Arthrodesis)

21.4

9.23

53.6

19.1

Lateral Lumbar Stenosis

SWDL with Fusion and Instrumentation

18.9

8.7

50.5

12.4

Study Design:	Controlled Trial

Authors and Year:	Kirkaldy-Willis, Wedge, Yong-Hing et al., 1982
Reporting:	Patient-reported
Method:	4 levels. Ex: great improvement, Gd: slight improvement, Fr: no improvement, Pr: worsening

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Lateral Lumbar Stenosis

Partial laminectomy or hemilaminectomy

120

Lateral Lumbar Stenosis with disk herniation

Partial laminectomy or hemilaminectomy

120

Lateral and Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

120

Lateral and Central Lumbar Stenosis with disk herniation

Partial laminectomy or hemilaminectomy

120

Authors and Year:	Mikhael, Ciric, Tarkington et al., 1981
Reporting:	Physician-reported
Method:	4 levels. Ex: Disabling low back and leg pain disappeared; Gd: Occasional slight backache or rarely paresthesia of the leg; Fr: Mild symptoms persisted or recurred; Pr: Gradually worsened.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Lateral Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Study Design:	Retrospective Trial with Consecutive Patients

Authors and Year:	Baba, Uchida, Maezawa et al., 1996
Reporting:	Patient-reported
Method:	2 levels: Excellent and Good: complete recovery or improved with minimal leg discomfort, Fair and Poor: residual radicular symptoms or symptoms and signs unchanged or worsened.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Lateral Lumbar Stenosis

Laminotomy

Authors and Year:	Sanderson and Getty, 1996
Reporting:	Patient-reported
Method:	3 levels based on patient satisfaction with leg pain. Good: improved, Fair: no Change, Poor: worse.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Lateral Lumbar Stenosis

Laminotomy

101

132

Authors and Year:	Aryanpur and Ducker, 1990
Reporting:	Patient-reported
Method:	3 levels. Good: complete relief of symptoms, No change, Worse

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Lateral Lumbar Stenosis

Laminotomy

Study Design:

Case-series

Authors and Year:

Choudhury and Taylor, 1977

Reporting:

Patient-reported

Method:

4 Levels: Excellent: Pain free, unrestricted activity. Good: Occasional pain, but normal activities. Fair: Improved capacity, but not full activity. Poor: No Improvement.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Lateral Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Epstein, Epstein, Rosenthal et al., 1972
Reporting:	Patient-reported
Method:	3 Levels: Excellent: Regained and maintained normal activity; Good: Minimal residual discomfort and disability. Able to return to work; Fair: Improved, but still had significant functional impairment.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Lateral Lumbar Stenosis

Foraminotomy/nerve root decompression

Trials Examining Surgical Patients with Central or Lateral Lumbar Stenosis (type ofstenosis unspecified or includes both types of stenosis)

Study Design:

Controlled Trial

Authors and Year:

Epstein, 1999

Reporting:

Physician-reported

Method:

Odom's Criteria, 4 Levels, Excellent, Good, Fair, Poor

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Ossification of the Posterior Longitudinal Ligament

SWDL-Standard Wide Decompressive Laminectomy

44.4

132

Ossification of the Yellow Ligament

SWDL-Standard Wide Decompressive Laminectomy

132

Authors and Year:

Yone and Sakou, 1999

Reporting:

Physician-reported

Method:

4 Levels, Excellent, Good, Fair, Poor, based on percent improvement. Presumable this is % improvement in overall JOE score, but this is not explicitly stated.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Mixed Stenosis with instability

Laminectomy

Mixed Stenosis with instability

Laminotomy with Fusion and Instrumentation

Mixed Stenosis without instability

Laminotomy

Authors and Year:

Javid and Hadar, 1998

Reporting:

Patient-reported

Method:

2 levels. Good: Successful; Poor: Unsuccessful.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

1.5

57.2

132

Central Lumbar Stenosis and Herniated Disk

SWDL-Standard Wide Decompressive Laminectomy

1.5

56.6

132

Lateral Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

1.5

86.6

132

Authors and Year:	Kalbarczyk, Lukes, and Seiler, 1998
Reporting:	Patient-reported
Method:	6-level scale. 1=Pain Free, 2= mild pain, 3=Fair pain, 4=slight pain relief, 5=unchanged, 6=worsened. No one got a 6.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Mixed Stenosis - without instability

SWDL-Standard Wide Decompressive Laminectomy

Mixed Stenosis - mild instability

Partial laminectomy or hemilaminectomy

Mixed Stenosis - high instability

Partial laminectomy and fusion

Authors and Year:	Kawauchi, Yone, and Sakou, 1996
Reporting:	Patient-reported
Method:	Stauffer's criteria (relief of back and leg pain, return to employment, restriction of physical activities, use of analgesic) [Good/Fair/Poor]

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Mixed Stenosis - slight adhesion

Partial laminectomy and fusion

Mixed Stenosis - moderate

Partial laminectomy and fusion

Authors and Year:	Pai and Kumar, 1996
Reporting:	Patient-reported
Method:	4-Level rating, Excellent, Good, Fair, Poor

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Congenital Stenosis

Decompressive Surgery

Mixed Stenosis

Decompressive Surgery

Authors and Year:	Cinotti, Postacchini, and Weinstein, 1994
Reporting:	Patient-reported
Method:	4 levels. Excellent: no leg pain, full normal activities. Good: some leg pain, normal activities. Fair: moderate pain, mild restriction of activities. Poor: little or no improvement, seriously restricted activities.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Mixed Stenosis - diabetes

SWDL-Standard Wide Decompressive Laminectomy

Mixed Stenosis - no diabetes

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Simpson, Silveri, Balderston et al., 1993
Reporting:	Physician-reported
Method:	4 levels. Based on patient symptoms, clinical results were rated as Excellent: no recurrence, no low-back dysfunction; Good: occasional pain; Fair: persistent symptoms with some limitations; Poor: condition same or worse.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis - diabetes

SWDL-Standard Wide
Decompressive Laminectomy

108

Mixed Stenosis - no diabetes

SWDL-Standard Wide
Decompressive Laminectomy

120

Authors and Year:	Nasca, 1989
Reporting:	Physician-reported
Method:	3 levels: Good Fair Poor

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Lateral Lumbar Stenosis

Decompressive Surgery

108

Central-mixed Stenosis

Decompressive Surgery

108

Central-mixed Stenosis

Decompressive Surgery with fusion and instrumentation

108

Post-surgical stenosis

Decompressive Surgery

Mixed Stenosis with instability

Decompressive Surgery with fusion and instrumentation

Degenerative Stenosis and scoliosis

Decompressive Surgery with fusion and instrumentation

Authors and Year:	Nather and Thomas, 1985
Reporting:
Method:	Patient reports 4 levels: Excellent, partial, same, worse. Doctor reports 4 levels: Excellent, Good, Fair, Poor. Both are stratified by diagnosis.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

Decompressive surgery with or without fusion

14
11

27.6
27.6

10
10

84
84

5
7

0
2

5
1

2
1

Mixed Stenosis and Congenital combined

Decompressive surgery with or without fusion

14
11

27.6
27.6

10
10

84
84

5
7

5
0

0
4

4
0

Authors and Year:	Paine, 1976
Reporting:	Patient-reported
Method:	4 Levels. Excellent: Returned to normal activities with little or no discomfort. Good: Minimal restrictions, occasional pain. Fair: Lighter or part-time employment, occasional debilitating pain. Poor: No work, limited activities.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Degenerative stenosis with disk herniation

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Shenkin and Hash, 1976
Reporting:	Physician-reported
Method:	3 level. Excellent: all pain has been relieved and resumed normal activity; Good: normal activities are resumed but has occasional complaints; Poor: all other results even though patient may have improved.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis - no prior surgery

SWDL-Standard Wide Decompressive Laminectomy

Mixed Stenosis - prior surgery for herniated disk

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Tile, McNeil, Zarins et al., 1976
Reporting:	Physician-reported
Method:	4 levels. Excellent, Good, Fair, Poor not defined.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

Mixed Decompression Techniques

240

Congenital Stenosis

SWDL-Standard Wide Decompressive Laminectomy

240

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Crock, Shiraishi, and Crock, 1995
Reporting:	Physician-reported
Method:	4 levels. Ex: complete relief of symptoms, Gd: pain improved, walking increased, Fr: Symptoms unchanged, Pr: deterioration in any on the of the three major symptoms (pain, bladder dysfunction, walking).

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

Partial laminectomy or hemilaminectomy

Authors and Year:	Silvers, Lewis, and Asch, 1993
Reporting:	Patient-reported
Method:	Patient satisfaction with surgery was scored as: yes, yes with some limitation, and no. Success was the sum of the first 2 scores.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

248

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

128

56.4

174

Authors and Year:	Katz, Lipson, Larson et al., 1991
Reporting:	Patient-reported
Method:	4 levels. 1: very satisfied, 2: Somewhat satisfied, 3: Somewhat dissatisfied, 4: Very dissatisfied

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

Mixed Decompression Techniques

Authors and Year:	Ganz, 1990
Reporting:	Physician-reported
Method:	Combined back and leg pain scores. Good: 4 to 6; Poor 0 to 3.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Study Design:	Case-series
Authors and Year:	Guigui, Benoist, Delecourt et al., 1998
Reporting:	Physician-reported
Method:	Provided pre- and postoperative mean scores from a questionnaire.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

Decompressive Surgery

50
50

7.6
16

Authors and Year:	Mackay and Wheelwright, 1998
Reporting:	Physician-reported
Method:	5 Levels: Excellent: pain free; Good: pain improved; Fair: pain improved but occasional medication; Marginal: pain improved but requires frequent medication; Poor: pain unimproved or worse.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

Partial laminectomy or hemilaminectomy

Authors and Year:	Scholz, Firsching, and Lanksch, 1998
Reporting:	Patient-reported
Method:	Two measures: One had 4 levels: A, no pain or complaints. B, improved. C, Unimproved. D, deteriorated. The other had 3 levels: Excellent or good, Indifferent, Not Satisfied.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

Decompressive Surgery

72
72
47

30
30
96

18
18

42
42

53
35

8
7

Authors and Year:	Tsai, Yang, and Bray, 1998
Reporting:
Method:	Doctors rated Excellent, Good, Fair Poor. Patients rated Very satisfied, somewhat sat., Somewhat dissatisfied and Very dissatisfied.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

Laminotomy

62
62

27
27

15
15

48
48

30
18

10
16

2
8

8
8

Authors and Year:	Spetzger, Bertalanffy, Reinges et al., 1997
Reporting:	Patient-reported
Method:	4 Levels: Excellent: Complete relief; Good: mild pain, normal activity and relief of claudication; Fair: Some improvement; Poor: Unchanged or worsened.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

Laminotomy

Authors and Year:	Katz, Lipson, Chang et al., 1996
Reporting:	Patient-reported
Method:	Two 4-level scales: Very satisfied, Somewhat satisfied, Somewhat dissatisfied, Very dissatisfied or Would patient have the operation again? Definitely, Probably, probably not, definitely not.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Stenosis

SWDL-Standard Wide Decompressive Laminectomy

55
55

84
84

120
120

37
30

6
12

1
6

9
7

Authors and Year:	Lehto and Honkanen, 1995
Reporting:	Patient-reported
Method:	4 Levels, Excellent, Good, Satisfactory, Poor

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

Decompressive Surgery

132

Authors and Year:	Stucki, Liang, Fossel et al., 1995
Reporting:	Patient-reported
Method:	4-Level Likert scale: Very satisfied, 1 point. Somewhat satisfied, 2 patients, Somewhat dissatisfied, 3pts. Very dissatisfied, 4 points.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

230

Mixed Stenosis

Decompressive Surgery

130

0.85

Authors and Year:	McCullen, Bernini, Bernstein et al., 1994
Reporting:
Method:	Patient reports 5 Levels: Very Satisfied, Satisfied, Somewhat Satisfied, Somewhat dissatisfied, Very Dissatisfied. Physician reports 3 Levels: Good, Fair, Poor.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

193

Mixed Stenosis

Decompressive Surgery

118
118

55
55

24
24

142
142

18
59

18
32

17
27

Authors and Year:	Brodsky, Hendricks, Khalil et al., 1989
Reporting:	Patient-reported
Method:	2 Levels: Good to Excellent or Fair to Poor

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

Fusion

55.2

390

Authors and Year:	Jalovaara, Lahde, Iikko et al., 1989
Reporting:	Patient-reported
Method:	4 levels, Good (Ex): none or slight pain, Fair (Gd): residual symptoms, Unchanged (Fr): no relief of symptoms, Worse (Pr): increased pain.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

44.4

Authors and Year:	Johnsson, Redlund-Johnell, Uden et al., 1989
Reporting:	Patient-reported
Method:	2 Levels: Good, or poor.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

156

Authors and Year:	Mauersberger and Nietgen, 1989
Reporting:	Patient-reported
Method:	3 Levels: Improved, unimproved, worse.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

Decompressive surgery with or without fusion

Authors and Year:	Boccanera, Pellicioni, and Laus, 1984
Reporting:	Physician-reported
Method:	3 levels- Good, Fair, Poor

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Hood and Weigl, 1983
Reporting:	Physician-reported
Method:	3 levels: Good, Fair, Poor

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Scafuri and Weinstein, 1981
Reporting:	Physician-reported
Method:	100 point scale based on pain, function, and physical findings. Excellent: 85-100; Good: 71-84; Fair: 60-70; Poor: less than 60.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

25
25

0
15.6

0
6

0
43

47.4
78.2

Authors and Year:	Echeverria and Lockwood, 1979
Reporting:	Both Patient and
Method:	4 Levels: Excellent, complete resolution; Good, Some disability and reduced activity; Fair, slight improvement; Poor, No improvement or worsened.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

45.6

168

Authors and Year:	Scapinelli, 1978
Reporting:	Physician-reported
Method:	3 Levels. Excellent: complete relief of pain and neurological features of lower limbs. Good: improvement of symptoms. Poor: no benefit.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Vestad and Naca, 1977
Reporting:	Patient-reported
Method:	3 Levels: Excellent, Fair, Poor

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

56.4

Authors and Year:	McKinley and Davis, 1976
Reporting:	Patient-reported
Method:	2 Levels: Successful or Not.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Teng and Papatheodorou, 1963
Reporting:	Patient-reported
Method:	4 Levels: Asymptomatic, Improved Slightly Improved, Unimproved.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Epstein, Epstein, and Lavine, 1962
Reporting:	Patient-reported
Method:	4 Levels: Excellent, Good, Fair, Poor.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

Mixed Decompression Techniques

Authors and Year:	Epstein, 1960
Reporting:	Patient-reported
Method:	4 Levels: Excellent, Good, Modest (Fair) and Failure (Poor)

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Trials Examining Surgical Patients with Degenerative Spondylolisthesis

Study Design:

Controlled Trial

Authors and Year:

Plotz and Benini, 1998

Reporting:

Physician-reported

Method:

5 Levels: Excellent: Pain at least 90% reduced; Good: Pain at least 70% Reduced; Fair: Pain at least 50% reduced requiring mild analgesics; Poor: Pain at least 50% reduced requiring strong analgesics or opiates; Worse.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

Decompressive Surgery without fusion

100

Authors and Year:	Satomi, Hirabayashi, Toyama et al., 1992
Reporting:	Patient-reported
Method:	JOA score from −6 to 15.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

Fusion and instrumentation

7.9

13.4

Degenerative Spondylolisthesis

Mixed Decompression Techniques

7.1

11.5

Authors and Year:	Lombardi, Wiltse, Reynolds et al., 1985
Reporting:	Physician-reported
Method:	5 Levels: Excellent, Good, Fair, Poor, Failure

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

32.4

Degenerative Spondylolisthesis

SWDL with Fusion (Arthrodesis)

32.4

Study Design:

Prospective Trial

Authors and Year:

Nakai, Yoshizawa, and Kobayashi, 1999

Reporting:

Patient-reported

Method:

Patient reported pain and requirement for medication.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

Fusion only

144

Study Design:

Randomized Controlled Trial

Authors and Year:

Fischgrund, Mackay, Herkowitz et al., 1997

Reporting:

Physician-reported

Method:

4 levels. Excellent (unrestricted and pain free), good (unrestricted and improved), fair (restricted and some pain), poor (no postsurgical improvement and still in pain).

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

Degenerative Spondylolisthesis

SWDL with Fusion (Arthrodesis)

Authors and Year:	Herkowitz and Kurz, 1991
Reporting:	Physician-reported
Method:	4 levels. Excellent: unrestricted activity, complete relief of pain, Good: occasional discomfort, major improvement, unrestricted, Fair: intermittent discomfort, improvement, restrictions, Poor: major discomfort, no improvement.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

Degenerative Spondylolisthesis

SWDL with Fusion (Arthrodesis)

Study Design:

Retrospective Trial with Consecutive Patients

Authors and Year:

Nishizawa and Fujimura, 1997

Reporting:

Patient-reported

Method:

JOA score: maximum 15

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

Fusion and instrumentation

7.3

128

13.3

Authors and Year:

Moller, Wittenberg, Nolte et al., 1992

Reporting:

Patient-reported

Method:

4 levels based on a questionnaire with 0-100 points accumulated for back pain, leg pain, Laseque sign, pain-free walking distance, use of analgesics, and need of braces or crutches. Ex 0-15, Gd 16-34, Acceptable 35-49, Fr 50-65, Pr >65.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

Fusion

46.8

Authors and Year:

Marchesi, Thalgott, and Aebi, 1991

Reporting:

Patient-reported

Method:

3 levels. Good: 75% back and leg pain relief, Fair: 25-75% back and leg pain relief, Poor: 25% back and leg pain relief.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

Authors and Year:

Takahashi, Kitahara, Yamagata et al., 1990

Reporting:

Patient-reported

Method:

Total score from the Japanese Orthopaedic Association, maximum 29 points, Satisfactory was 25 points or more

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

Fusion

13.2

151

360

24.4

Authors and Year:

Knox, Harvell, Nelson et al., 1989

Reporting:

Patient-reported

Method:

4 levels of satisfaction. Very satisfied (no symptoms), Satisfied (much better), Somewhat satisfied (somewhat better), Unsatisfied (same or worse)

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

21.3

Study Design:

Case-series

Authors and Year:

Booth, Bridwell, Eisenberg et al., 1999

Reporting:

Physician-reported

Method:

3 Levels of Patient satisfaction.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

Partial laminectomy with fusion and instrumentation

129

Authors and Year:	Epstein, 1998a
Reporting:	Physician-reported
Method:	4-Level Scale: Excellent, Good, Fair, Poor.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

290

Mixed Stenosis Mixed

Decompression Techniques

290

120

324

200

Authors and Year:	Epstein, 1998b
Reporting:	Physician-reported
Method:	4-Level scale: Excellent, Good, Fair, Poor.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

Authors and Year:	McCulloch, 1998
Reporting:
Method:	Patient reported satisfaction yes/no, Physician reported success Yes/No

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

Partial laminectomy and fusion

Authors and Year:	Mochida, Toh, Suzuki et al., 1997
Reporting:	Physician-reported
Method:	JOA score, which was neither referenced nor defined. At least 12 out of 15 points was considered a satisfactory response.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

Partial laminectomy with fusion and instrumentation

13.3

0.9

Authors and Year:	Chang and McAfee, 1989
Reporting:	Physician-reported
Method:	Excellent, Good, fair, Poor

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

15.3

Authors and Year:	Herron and Trippi, 1989
Reporting:	Physician-reported
Method:	3 levels: Good, Fair, Poor

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Hanley, 1986
Reporting:	Physician-reported
Method:	4 Levels: Excellent, Good, Fair, Poor

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

31.6

Authors and Year:	Kaneda and Kazama, 1986
Reporting:	Physician-reported
Method:	4-level outcome based on a 12-point scale

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

54
54

0
30

19
6

35
2

Authors and Year:	Dall and Rowe, 1985
Reporting:	Patient-reported
Method:	2 Levels: Better or Worse

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Epstein, Epstein, Carras et al., 1983
Reporting:	Physician-reported
Method:	3 levels. Excellent: full/minimal restrictions, Good: moderate restriction, Poor: no improvement to worsening.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

Mixed Decompression Techniques

Authors and Year:	Richardson and Brown, 1980
Reporting:	Physician-reported
Method:	5 levels. Ex: no pain with full activity, Satisfactory (Gd): minimal pain not incapacitated, Fr: residual pain but improved, Pr: not working, minor improvement, Failure: no improvement or not working.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

SWDL with Fusion (Arthrodesis)

Authors and Year:	Cauchoix, Benoist, and Chassaing, 1976
Reporting:	Patient-reported
Method:	4 Levels: Free from pain (Excellent), Slight and temporary sciatica (Good), Not Improved (Poor), Recurrence of pain after increasing of slipping (Very Poor). Terms in parentheses are by ECRI and did not appear in the published study.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

Trials Examining Surgical Patients with Lumbar Stenosis and/or Degenerative Spondylolisthesis

Study Design:	Controlled Trial

Authors and Year:	Rompe, Eysel, Zollner et al., 1999
Reporting:	Patient-reported
Method:	3 levels. Patients were asked if they were Satisfied, Moderately satisfied, or Unsatisfied.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

88.8

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

88.8

Authors and Year:	Katz, Lipson, Lew et al., 1997
Reporting:	Patient-reported
Method:	2 levels. Satisfied of Not Satisfied. Based on questions regarding improvement in pain, relief of sensory dysfunction, ability to do recreational activities, satisfaction with overall results.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

194

Mixed Stenosis / Sponsylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

194

144

194

140

Mixed Stenosis and Spondylolisthesis

SWDL with Fusion (Arthrodesis)

Mixed Stenosis and Spondylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Rompe, Eysel, Hopf et al., 1995
Reporting:	Patient-reported
Method:	3 levels: Good-to-excellent, Fair, Poor.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Mixed Stenosis

SWDL with Fusion and Instrumentation

21.6

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

25.9

Mixed Stenosis and Spondylolisthesis

SWDL with Fusion and Instrumentation

25.6

Authors and Year:	Postacchini, Cinotti, Perugia et al., 1993
Reporting:	Patient-reported
Method:	4 levels. Ex 81-100, Gd 61-80, Fr41-60, Pr0-40. Score is passed on points for subjective opinion of back and leg pain, physician rating of nerve-root tension, motor deficit, analgesics, ability to work, ADL, and walking ability.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Congenital or Degenerative Stenosis, Combined, or Deg. Spondylolisthesis

Laminotomy

44.4

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

44.4

Authors and Year:	Sanderson and Wood, 1993
Reporting:	Patient-reported
Method:	3 levels. Ex: no leg pain, Gd: less leg pain and could walk further, Pr: continued leg pain and no improvement in walking.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

Partial laminectomy or hemilaminectomy

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Hirabayashi, Kumano, and Kuroki, 1991
Reporting:	Patient-reported
Method:	4 levels but reported as 2. Excellent and Good: no postoperative complaints or improved with some complaints, Fair and Poor: no improvement or worse.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

Mixed Stenosis

SWDL with Fusion and Instrumentation

Authors and Year:	Herkowitz and Garfin, 1989
Reporting:	Physician-reported
Method:	2 levels: Good to excellent or poor.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Degenerative Spondylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

Study Design:	Prospective Trial
Authors and Year:	Jonsson, Annertz, Sjoberg et al., 1997a
Reporting:	Patient-reported
Method:	4 levels. Ex: pain-free, Fair (Gd): improved but residual pain, Unchanged (Fr), Worse (Pr)

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

105

Central Spinal Stenosis and Degenerative Spondylolisthesis

Partial laminectomy or hemilaminectomy

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Postacchini, Cinotti, Gumina et al., 1993
Reporting:	Physician-reported
Method:	2 levels, Ex & Gd, Fr & Pr. Determined from subjective pain score (0-50) each for back and leg pain, and examiner assessment of range of motion, nerve root tension, muscle strength, medication, work, walking, and ADL.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Developmental, degenerative, or combined, with or without spondylolisthesis

Mixed Decompression Techniques

252

Study Design:	Case-series
Authors and Year:	Guigui, Barre, Benoist et al., 1999
Reporting:	Physician-reported
Method:	2 levels, improved v. not improved. Clinical evaluation based on the Beaujon Scoring System using claudication, radiculalgia, low back pain, motor and sensory deficit, medication, and quality of life, was used to determine level of improvement.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Stenosis and/or Spondylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

Trials Examining Surgical Patients and PatientsReceiving Conservative Treatment

Patient Condition:	Central lumbar stenosis
Study Design:	Controlled Trial
Authors and Year:	Simotas, Dorey, Hansraj, et al., 2000
Reporting:	Patient-reported
Method:	Patients were asked how satisfied they were with the overall results of treatment. 4 levels. Ex: very satisfied, Gd: somewhat satisfied, Fr: somewhat dissatisfied, Pr: very dissatisfied.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

Conservative-various treatments

Central Lumbar Stenosis

Surgery - not described

Authors and Year:	Mariconda, Zanforlino, Celestino et al., 2000
Reporting:	Patient-reported
Method:	0-20 score from the Beaujon Scoring System. Measures walking, leg pain at rest and exertion, low back pain, neurological deficit, medications required, and quality of life.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

8.1

2.7

14.4

4.1

13.8

4.4

Central Lumbar Stenosis

Control/Placebo/None

2.4

14.8

2.2

14.2

3.6

Authors and Year:	Johnsson, Uden, and Rosen, 1991
Reporting:	Patient-reported
Method:	3 levels determined by a 0-100 visual analog scale. Good (improved) 56-100, Fair (unchanged) 46-55, Poor (worse) 0-45.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

Conservative-not described

Central Lumbar Stenosis - moderate stenosis

SWDL-Standard Wide Decompressive Laminectomy

109

Central Lumbar Stenosis - severe stenosis

SWDL-Standard Wide Decompressive Laminectomy

120

Patient Condition:	Mixed lumbar stenosis
Study Design:	Randomized Controlled Trial
Authors and Year:	Amundsen, Weber, Nordal, et al. 2000
Reporting:	Physician-reported
Method:	Excellent: full or almost full resolution of pain and return to normal physical activity; Fair: partial resolution, with lesser problems clear improvement; Unchanged (Poor): no change in the clinical condition; Worse (V Poor): worsening clinical condition

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

120

Mixed Stenosis

Conservative-various

120

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

120

Mixed Stenosis

Conservative-various

120

Study Design:	Controlled Trial
Authors and Year:	Hurri, Slatis, Soini et al., 1998
Reporting:	Patient-reported
Method:	3 levels. Patients were asked if condition were much better and improved (Good), unchanged (Fair), worse (Poor)

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

144

Mixed Stenosis

Conservative-not described

144

Authors and Year:	Atlas, Deyo, Keller et al., 1996
Reporting:	Patient-reported
Method:	2 levels. Gd: Satisfied, Pr: Unsatisfied

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Mixed Stenosis

Conservative-many

Authors and Year:	Atlas, Keller, Robson, et al. 2000
Reporting:	Patient-reported
Method:	See Atlas, Deyo, Keller, et al. 1996

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Mixed Stenosis

Conservative-not described

Authors and Year:	Swezey, 1996
Reporting:	Patient-reported
Method:	3 levels. Improved, Unchanged, Worsened since initial diagnoses.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

Exercise/stretching and flexibility

Mixed Stenosis

Physical Therapy/massage, ultrasound, heat, ice, traction

Mixed Stenosis

Epidural Steroid Injections

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Nagler and Bodack, 1993
Reporting:	Patient-reported
Method:	5 levels. Based on the ratio of original symptoms and symptoms at one year. Ex: 76-100%, Gd: 51-75%, Fr: 26-50%, Slight: 1-25%, Same or worse: 0%. Symptoms were pain, functioning, medication, and bladder problems.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

Conservative-various

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Patient Condition:	Degenerative Spondylolisthesis
Study Design:	Controlled Trial
Authors and Year:	Fitzgerald and Newman, 1976
Reporting:	Physician-reported
Method:	2 levels. Patients were asked if they were better, unchanged, or worse as a result of treatment and classified as satisfactory or unsatisfactory.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

Rigid Brace

216

Degenerative Spondylolisthesis

Mixed Decompression Techniques

216

Authors and Year:	Rosenberg, 1976
Reporting:	Patient-reported
Method:	2 levels. Patient reported satisfactory or unsatisfactory relief of pain and symptoms after therapy.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

Partial laminectomy or hemilaminectomy

Degenerative Spondylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

15
11

1
24

12
120

11
11

4
0

170

Degenerative Spondylolisthesis

Conservative-not described

170

312

153

Evidence Table 17. Leg Pain Outcomes Related to Treatment of Lumbar Spinal Stenosis

Trials Examining Surgical Patients with Central Lumbar Stenosis

Study Design:	Controlled Trial
Authors and Year:	Hanakita, Suwa, and MIzuno, 1999
Reporting:	Patient-reported
Method:	3 levels. Gd: Improved, Fr: Unchanged, Pr: Worse.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis - younger than 64 years

SWDL-Standard Wide Decompressive Laminectomy

Central Lumbar Stenosis - older than 64 years

SWDL-Standard Wide Decompressive Laminectomy

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

Central Lumbar Stenosis

SWDL with Fusion (Arthrodesis)

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Vitaz, Raque, Shields et al., 1999
Reporting:	Patient-reported
Method:	3 levels. No change, Improved, and Resolved

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

Mixed Decompression Techniques

19.6

Authors and Year:	Jonsson and Stromqvist, 1994
Reporting:	Patient-reported
Method:	4 levels. Ex: pain-free, Gd: improved but residual pain, Unchanged (Fr), Worse (Pr).

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

Study Design:	Case-series
Authors and Year:	Johnsson, Willner, and Pettersson, 1981
Reporting:	Patient-reported
Method:	Number of patients with back and leg pain

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Trials Examining Surgical Patients with Lateral Lumbar Stenosis

Study Design:

Controlled Trial

Authors and Year:

Kirkaldy-Willis, Wedge, Yong-Hing et al., 1982

Reporting:

Patient-reported

Method:

4 levels. None, Mild, Moderate, Severe

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Lateral Lumbar Stenosis

Partial laminectomy or hemilaminectomy

120

Lateral Lumbar Stenosis with disk herniation

Partial laminectomy or hemilaminectomy

120

Lateral and Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

120

Lateral and Central Lumbar Stenosis with disk herniation

Partial laminectomy or hemilaminectomy

120

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Sanderson and Getty, 1996
Reporting:	Patient-reported
Method:	3 levels. Good: No analgesia, Fair: Occasional analgesia, Poor: Continual analgesia

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Lateral Lumbar Stenosis

Laminotomy

101

132

Study Design:	Case-series
Authors and Year:	Choudhury and Taylor, 1977
Reporting:	Patient-reported
Method:	3 Levels: Absent, Mild (Occasional), Recurring

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Lateral Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Trials Examining Surgical Patients with Central or Lateral Lumbar Stenosis (type of stenosis unspecified or includes both types of stenosis)

Study Design:	Controlled Trial
Authors and Year:	Yone and Sakou, 1999
Reporting:	Physician-reported
Method:	JOA score

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis with instability

Laminotomy

1.5

Mixed Stenosis with instability

Laminotomy with Fusion and Instrumentation

1.9

Mixed Stenosis without instability

Laminotomy

1.1

2.3

Authors and Year:	Javid and Hadar, 1998
Reporting:	Patient-reported
Method:	5 levels. Ex: None, Gd: Rarely, Fr: Sometimes, Pr: most times, VPr: constant

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

57.2

132

Central Lumbar Stenosis and Herniated Disk

SWDL-Standard Wide Decompressive Laminectomy

56.6

132

Lateral Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

86.6

132

Study Design:

Case-series

Authors and Year:

Mackay and Wheelwright, 1998

Reporting:

Patient-reported

Method:

Yes or no, pre and post

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

Partial laminectomy or hemilaminectomy

Authors and Year:	Tsai, Yang, and Bray, 1998
Reporting:	Patient-reported
Method:	Analog scale 0-20

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

Laminotomy

15.2

5.7

5.8

7.1

Authors and Year:	Katz, Lipson, Chang et al., 1996
Reporting:	Patient-reported
Method:	3 Levels: Severe or very severe, Moderate or mild, Very Mild or none.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Stenosis

SWDL-Standard Wide Decompressive Laminectomy

120

Authors and Year:	Simmons and Simmons, 1992
Reporting:	Patient-reported
Method:	4 levels. None, Mild (minimal disruption of lifestyle), Moderate (significant disruption of lifestyle, Severe (constant pain and problems with all activities).

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL with Fusion and Instrumentation

Trials Examining Surgical Patients with Degenerative Spondylolisthesis

Study Design:	Randomized Controlled Trial
Authors and Year:	Fischgrund, Mackay, Herkowitz et al., 1997
Reporting:	Patient-reported
Method:	Visual analog scale from 0 (no pain) to 5 (severe pain).

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

Degenerative Spondylolisthesis

SWDL with Fusion (Arthrodesis)

Authors and Year:	Herkowitz and Kurz, 1991
Reporting:	Patient-reported
Method:	Scale of no pain (0) to severe pain (5).

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

1.7

Degenerative Spondylolisthesis

SWDL with Fusion (Arthrodesis)

4.3

Study Design:	Controlled Trial
Authors and Year:	Satomi, Hirabayashi, Toyama et al., 1992
Reporting:	Patient-reported
Method:	JOA score 0 (severe pain)-3 (no pain)

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

Fusion and instrumentation

1.3

2.2

Degenerative Spondylolisthesis

Mixed Decompression Techniques

Study Design:

Retrospective Trial with Consecutive Patients

Authors and Year:

Stambough, 1999

Reporting:

Patient-reported

Method:

Visual analog scale of 0 (no pain) to 10 (severe pain)

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

8.5

45.2

105

0.5

Authors and Year:	Nishizawa and Fujimura, 1997
Reporting:	Patient-reported
Method:	JOA score: 0 (severe pain) to 3 (no pain)

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

Fusion and instrumentation

1.3

128

2.8

Authors and Year:	Knox, Harvell, Nelson et al., 1989
Reporting:	Patient-reported
Method:	Scale of 0 (none) to 10 (severe)

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

6.4

21.3

3.4

Study Design:	Case-series
Authors and Year:	Inoue, Watanabe, Goto et al., 1988
Reporting:
Method:	4-Level score on JOA scale

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

Fusion

1.1

127

324

2.7

Trials Examining Surgical Patients with Lumbar Stenosis and/or Degenerative Spondylolisthesis

Study Design:	Controlled Trial
Authors and Year:	Katz, Lipson, Lew et al., 1997
Reporting:	Patient-reported
Method:	Scale of 1 to 5 with 1 being no pain and 5 being very severe pain.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

194

Mixed Stenosis / Sponsylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

194

3.4

2.3

2.4

Mixed Stenosis and Spondylolisthesis

SWDL with Fusion (Arthrodesis)

3.4

1.1

2.1

Mixed Stenosis and Spondylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

3.6

2.1

Trials Examining Surgical Patients and Patients Receiving Conservative Treatment

Study Design:	Controlled Trial
Authors and Year:	Simotas, Dorey, Hansraj, et al., 2000
Reporting:	Patient-reported
Method:	3 levels. Good: None or mild pain, Fair: Moderate pain, Poor: Very severe or severe pain

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

Conservative-various treatments

Central Lumbar Stenosis

Surgery - not described

Authors and Year:	Mariconda, Zanforlino, Celestino et al., 2000
Reporting:	Patient-reported
Method:	0, 1, 2, 3 scale: 0- continuous severe pain, 1- occasional severe pain, 2- occasional mild pain, 3- none

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

1.4

1.1

1.9

1.2

Central Lumbar Stenosis

Control/Placebo/None

1.7

0.9

2.2

2.1

0.9

Evidence Table 18. Leg Pain Relief Outcomes Related to Treatment of Lumbar Spinal Stenosis

Trials Examining Surgical Patients with Central Lumbar Stenosis

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Ishac, Alhayek, Fournier et al., 1996
Reporting:	Physician-reported
Method:	Reported relief of symptoms

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

0.2

Study Design:	Prospective Trial
Authors and Year:	Kleeman, Hiscoe, and Berg, 2000
Reporting:	Patient-reported
Method:	4 levels: Resolved, Better, Same, Worse

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

Study Design:	Case-series
Authors and Year:	Young, Veerapen, and O'Laoire, 1988
Reporting:
Method:	2 levels- Relieved or not. Also 3 levels- relieved of claudication, significantly improved, not improved.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

Decompressive Surgery

39.8

Authors and Year:	Verbiest, 1979
Reporting:	Patient-reported
Method:	2 Levels: Cured or Residual Symptoms

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Congenital Lumbar Stenosis

SWDL with Fusion (Arthrodesis)

123

204

Trials Examining Surgical Patients with Lateral Lumbar Stenosis

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Baba, Uchida, Maezawa et al., 1996
Reporting:	Physician-reported
Method:	Reported number of patients with leg pain before and after surgery.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Lateral Lumbar Stenosis

Laminotomy

Trials Examining Surgical Patients with Central or Lateral Lumbar Stenosis (type ofstenosis unspecified or includes both types of stenosis)

Study Design:	Controlled Trial
Authors and Year:	Yone and Sakou, 1999
Reporting:	Physician-reported
Method:	Percent change in JOA score

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis with instability

Laminotomy

Mixed Stenosis with instability

Laminotomy with Fusion and Instrumentation

Mixed Stenosis without instability

Laminotomy

Authors and Year:	Jonsson and Stromqvist, 1993a
Reporting:	Physician-reported
Method:	4 levels. Excellent: pain-free, Fair: improved but with residual pain, Unchanged, Poor: deteriorated.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

Lateral Lumbar Stenosis

Partial laminectomy or hemilaminectomy

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Ganz, 1990
Reporting:	Physician-reported
Method:	4 levels. 0- No improvement, 1-Some improvement, 2-Almost normal, 3-No symptoms

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

2.45

Trials Examining Surgical Patients with Degenerative Spondylolisthesis

Study Design:	Controlled Trial
Authors and Year:	Plotz and Benini, 1998
Reporting:	Patient-reported
Method:	3 Levels: Improved, Unchanged, Worse.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

Decompressive Surgery without fusion

120

Degenerative Spondylolisthesis

Decompressive Surgery with fusion and Translaminar Screw Fixation

100

Degenerative Spondylolisthesis

Decompressive Surgery with fusion and AO Internal Fixator

100

Authors and Year:	Yuan, Garfin, Dickman et al., 1994
Reporting:	Physician-reported
Method:	3 levels. Improved, No change, Worse

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

2177

Degenerative Spondylolisthesis

Fusion and Pedical Screw Fixation

2125

1945

176

456

Degenerative Spondylolisthesis

Fusion

451

398

Study Design:	Case-series
Authors and Year:	Herron and Trippi, 1989
Reporting:	Patient-reported
Method:	Average % relief, number of patients with complete relief.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

Trials Examining Surgical Patients with Lumbar Stenosis and/or Degenerative Spondylolisthesis

Study Design:	Controlled Trial
Authors and Year:	Postacchini, Cinotti, Perugia et al., 1993
Reporting:	Patient-reported
Method:	Improvement based on a 0-100 scale with 0 meaning greatest disability.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Congenital or Degenerative Stenosis, Combined, or Deg. Spondylolisthesis

Laminotomy

44.4

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

44.4

Trials Examining Surgical Patients and Patients Receiving Conservative Treatment

Study Design:	Randomized Controlled Trial
Authors and Year:	Amundsen, Weber, Nordal, et al. 2000
Reporting:	Patient-reported
Method:	3 levels of pain were recorded: Good: No or Light pain, Fair: Moderate pain, and Poor: Severe pain

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

120

Mixed Stenosis

Conservative-various

120

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

120

Mixed Stenosis

Conservative-various

120

Study Design:	Controlled Trial
Authors and Year:	Atlas, Deyo, Keller et al., 1996
Reporting:	Patient-reported
Method:	3 levels. Gd: Better, Fr: Same, Pr: Worse.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Mixed Stenosis

Conservative-many

Authors and Year:	Atlas, Keller, Robson, et al. 2000
Reporting:
Method:	See Atlas, Deyo, Keller, et al. 1996

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Mixed Stenosis

Conservative-not described

Evidence Table 19. Mental Status Outcomes from Clinical Trials of Patients with Lumbar Spinal Stenosis

Trials Examining Surgical Patients with Degenerative Spondylolisthesis

Study Design:

Randomized Controlled Trial

Authors and Year:

Thomsen, Christensen, Eiskjaer et al., 1997

Reporting:

Patient-reported

Method:

Dallas Pain Questionnaire. 3 questions measure anxiety-depression.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

Partial laminectomy with fusion and instrumentation

Degenerative Spondylolisthesis

Partial laminectomy and fusion

Study Design:

Case-series

Authors and Year:

Booth, Bridwell, Eisenberg et al., 1999

Reporting:

Patient-reported

Method:

5 levels: Much Better, Better, Same, Worse, Much Worse.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

Partial laminectomy with fusion and instrumentation

129

Evidence Table 20. Physical Function and Activities of Daily Living Outcomes Related to Treatment of Lumbar Spinal Stenosis

Trials Examining Surgical Patients with Centralor Lateral Lumbar Stenosis (type of stenosis unspecified or includes bothtypes of stenosis)

Study Design:	Controlled Trial
Authors and Year:	Simpson, Silveri, Balderston et al., 1993
Reporting:	Patient-reported
Method:	Patient reported motor weakness as absent or present at long term followup.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis - diabetes

SWDL-Standard Wide Decompressive Laminectomy

Mixed Stenosis - no diabetes

SWDL-Standard Wide Decompressive Laminectomy

120

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Silvers, Lewis, and Asch, 1993
Reporting:	Patient-reported
Method:	4 levels: Excellent, Good, Fair, Poor. Excellent and Good were combined as a successful outcome.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

248

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

128

56.4

174

Study Design:	Case-series
Authors and Year:	McCullen, Bernini, Bernstein et al., 1994
Reporting:	Patient-reported
Method:	5 Levels: Does activity have No limits, Few Limits, Some Limits, Many Limits, Disabling.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

193

Mixed Stenosis

Decompressive Surgery

118

142

Trials Examining Surgical Patients with Degenerative Spondylolisthesis

Study Design:	Randomized Controlled Trial
Authors and Year:	Thomsen, Christensen, Eiskjaer et al., 1997
Reporting:	Patient-reported
Method:	Dallas Pain Questionnaire. 10 questions measure daily activities and work-leisure activities.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

Partial laminectomy with fusion and instrumentation

Degenerative Spondylolisthesis

Partial laminectomy and fusion

Study Design:	Controlled Trial
Authors and Year:	Yuan, Garfin, Dickman et al., 1994
Reporting:	Physician-reported
Method:	3 levels. Improved, No change, Worse

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

2177

Degenerative Spondylolisthesis

Fusion and Pedical Screw Fixation

2132

1927

192

456

Degenerative Spondylolisthesis

Fusion

451

391

Study Design:	Prospective Trial
Authors and Year:	Rechtine, Sutterlin, Wood et al., 1996
Reporting:	Patient-reported
Method:	5-point scale used to determine improvement. Bedridden, Rare activity, Limited activity, Moderate daily activity, Normal daily activity.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Takahashi, Kitahara, Yamagata et al., 1990
Reporting:	Patient-reported
Method:	7 activities of daily living with a maximum of 14 points.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

Fusion

6.2

151

360

11.7

Study Design:	Case-series
Authors and Year:	Booth, Bridwell, Eisenberg et al., 1999
Reporting:	Patient-reported
Method:	5 Levels of activity: Bedridden, Primarily no activity, Light labor, Moderate labor, No restrictions.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

Partial laminectomy with fusion and instrumentation

129

Authors and Year:	Inoue, Watanabe, Goto et al., 1988
Reporting:	Physician-reported
Method:	14 point JOA scale

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

Fusion

4.9

127

324

11.7

Trials Examining Surgical Patients with Lumbar Stenosis and/or Degenerative Spondylolisthesis

Study Design:	Controlled Trial
Authors and Year:	Rompe, Eysel, Zollner et al., 1999
Reporting:	Patient-reported
Method:	4 levels. Low Back Outcome Scale. Ex (65-75), Gd (50-64), F (30-49), P (0-29) Score based on physical activities and activities of daily living.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

88.8

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

88.8

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Chen, Baba, Kamitani et al., 1994
Reporting:	Physician-reported
Method:	4 levels, Japanese Orthopaedic Association Assessment Scoring System. Based on back pain, leg pain, walking, sensory disturbance, motor disturbance, ADL (48% of score) urinary function. Ex: improvement >80%, Gd: 65-80%, Fr: 50-65%, Pr:<50%.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Developmental, degenerative, or combined stenosis, or degenerative or isthmic spondylolisthesis

Mixed Decompression Techniques

Trials Examining Surgical Patients and Patients Receiving Conservative Treatment

Study Design:	Controlled Trial
Authors and Year:	Atlas, Deyo, Keller et al., 1996
Reporting:	Patient-reported
Method:	Score based on Short Form 36 score. The higher the score the better the physical function.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

27.6

54.1

Mixed Stenosis

Conservative-many

44.7

45.7

Authors and Year:	Herno, Airaksinen, Saari et al., 1996
Reporting:	Physician-reported
Method:	Patient's functional status was evaluated during the clinical examination. Good: normal or near normal activities such as walking, dressing, turning around; Poor: difficulty performing activities

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

Conservative-not described

Evidence Table 21. Quality of Life Outcomes Related to Treatment of Lumbar Spinal Stenosis

Trials Examining Surgical Patients with Degenerative Spondylolisthesis

Study Design:	Randomized Controlled Trial
Authors and Year:	Thomsen, Christensen, Eiskjaer et al., 1997
Reporting:	Patient-reported
Method:	Dallas Pain Questionnaire. 3 questions measure social concerns.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Degenerative Spondylolisthesis

Partial laminectomy with fusion and instrumentation

Degenerative Spondylolisthesis

Partial laminectomy and fusion

Trials Examining Surgical Patients and Patients Receiving Conservative Treatment

Patient Condition:	Central lumbar stenosis
Study Design:	Controlled Trial
Authors and Year:	Mariconda, Zanforlino, Celestino et al., 2000
Reporting:	Patient-reported
Method:	0, 1, 2, 3 scale: 0- completely incapacitated, 1- very limited, 2- slightly limited, 3- normal

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

1.3

0.7

2.3

0.6

2.2

0.7

Central Lumbar Stenosis

Control/Placebo/None

1.8

0.8

2.4

0.5

2.5

0.5

Patient Condition:	Mixed lumbar stenosis
Study Design:	Controlled Trial
Authors and Year:	Atlas, Deyo, Keller et al., 1996
Reporting:	Patient-reported
Method:	2 levels. Number of patients reporting moderate or better improvement in quality of life

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Mixed Stenosis

Conservative-many

Authors and Year:	Atlas, Keller, Robson, et al. 2000
Reporting:
Method:	See Atlas, Deyo, Keller, et al. 1996

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Mean

Rating Category

Mean

Min.

Max.

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Mixed Stenosis

Conservative-not described

Evidence Table 22. Walking Capacity Outcomes Related to Treatment of Lumbar Spinal Stenosis

Randomized Controlled Trials of Patients Receiving Conservative Treatments

Patient Condition:	Mixed lumbar stenosis
Study Design:	Randomized Control Trial
Authors and Year:	Fukusaki, Kobayashi, Hara et al., 1998
Reporting:	Physician-reported
Method:	Observation by blinded physical therapist of walking distance provoking intolerable pain. Mean and SD of distance walked and a 3-level success rating were reported. Excellent =>100M, Good=20-100M, Poor =<20M.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Mixed Stenosis

Epidural Saline

0.25

Mixed Stenosis

Epidural Anesthetics

0.25

Mixed Stenosis

Epidural Anesthetics and Steroids

0.25

Trials Examining Surgical Patients with Central Lumbar Stenosis

Study Design:	Randomized Controlled Trial
Authors and Year:	Grob, Humke, and Dvorak, 1995
Reporting:	Patient-reported
Method:	Average distance in meters that the patient could walk without pain.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

1400

6600

Central Lumbar Stenosis - single level

Partial laminectomy with fusion and instrumentation

400

4600

Central Lumbar Stenosis - multiple segments

Partial laminectomy with fusion and instrumentation

200

3800

Study Design:	Controlled Trial
Authors and Year:	Hanakita, Suwa, and MIzuno, 1999
Reporting:	Patient-reported
Method:	3 levels. Gd: Improved, Fr: Unchanged, Pr: Worse.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis - younger than 64 years

SWDL-Standard Wide Decompressive Laminectomy

Central Lumbar Stenosis - older than 64 years

SWDL-Standard Wide Decompressive Laminectomy

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

Central Lumbar Stenosis

SWDL with Fusion (Arthrodesis)

Authors and Year:	Herno, Partanen, Talaslahti et al., 1999
Reporting:	Physician-reported
Method:	The walking capacity was evaluated on a treadmill with a speed of 3600 m/h and a maximum time of 15 minutes (900m).

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis - post surgery stenosis

SWDL-Standard Wide Decompressive Laminectomy

133

113

157

470

Central Lumbar Stenosis - no post surgery stenosis

SWDL-Standard Wide Decompressive Laminectomy

122

113

157

515

Authors and Year:	Herno, Saari, Suomalainen et al., 1999
Reporting:	Physician-reported
Method:	The walking capacity was evaluated on a treadmill with a speed of 3600 m/h and a maximum time of 15 minutes (900m).

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis - no postsurgery stenosis

Mixed Decompression Techniques

706

Central Lumbar Stenosis - post surgery stenosis

Mixed Decompression Techniques

602

Authors and Year:	Thomas, Rea, Pikul et al., 1997
Reporting:	Patient-reported
Method:	Visual analog scale of 0 (mild) -10 (severe) pain. Also graded for number of city blocks walked without pain Ex: >3, Gd: 1-3, Fr: 1/2-1, Pr: 1/4-1/2, VPr: <1/4.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

6.8

2.7

37.6

4.2

2.8

Central Lumbar Stenosis

Laminotomy

37.6

Authors and Year:	Yone, Sakou, Kawauchi et al., 1996
Reporting:	Patient-reported
Method:	JOA scale of 0 (< 100 m then pain) to 3 (normal walking).

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL with Fusion and Instrumentation

0.3

2.1

Central Lumbar Stenosis

Laminotomy

0.4

1.7

Study Design:	Prospective Trial
Authors and Year:	Kleeman, Hiscoe, and Berg, 2000
Reporting:	Patient-reported
Method:	Endurance in minutes up to unlimited

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

7.4

Authors and Year:	Weiner, Walker, Brower et al., 1999
Reporting:	Patient-reported
Method:	Meter walked

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

109

467

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Vitaz, Raque, Shields et al., 1999
Reporting:	Patient-reported
Method:	4 levels. Stage 1: minimal or no limitation, 2: mild-to moderate limitation, 3: severe limitation, 4: bedridden or wheelchair bound.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

Mixed Decompression Techniques

19.6

Authors and Year:	Airaksinen, Herno, Turunen et al., 1997
Reporting:	Patient-reported
Method:	4 levels. Excellent = could walk a mile; Good = could walk without assistance; Poor = could walk with crutch; Very Poor = could only crawl.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

497

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

438

171

241

Authors and Year:	Ishac, Alhayek, Fournier et al., 1996
Reporting:	Physician-reported
Method:	4 levels. Resolved, Improved, Unchanged, Worsened

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

0.2

Authors and Year:	Mullin, Rea, Irsik et al., 1996
Reporting:	Patient-reported
Method:	5 level rating scale. Ex: walks normally, Gd: walks unaided but with difficulty, Fr: needs aid to climb stairs, Pr: needs aid to walk on flat surface, V Pr: unable to walk.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Jonsson and Stromqvist, 1994
Reporting:	Patient-reported
Method:	4 levels. Ex: more than 5 km, Gd: 1-5 km, Fr: 0.5-1 km, Pr: less than .5 km.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

Study Design:	Case-series
Authors and Year:	Hall, Bartleson, Onofrio et al., 1985
Reporting:	Patient-reported
Method:	Distance walked

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

180

2400

Authors and Year:	Johnsson, Willner, and Pettersson, 1981
Reporting:	Patient-reported
Method:	Distance in meters until pain starts.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

262

579

1819

2031

Authors and Year:	Verbiest, 1979
Reporting:	Patient-reported
Method:	2 Levels: Claudication Cured or Residual Symptoms

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Congenital Lumbar Stenosis

SWDL with Fusion (Arthrodesis)

123

204

Trials Examining Surgical Patients with Lateral Lumbar Stenosis

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Baba, Uchida, Maezawa et al., 1996
Reporting:	Physician-reported
Method:	Reported number of patients who could walk 500 meters or less before and after surgery.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Lateral Lumbar Stenosis

Laminotomy

Authors and Year:	Sanderson and Getty, 1996
Reporting:	Patient-reported
Method:	3 levels. Good: unrestricted walking > 1 hr, Fair: 30 minutes to 1 hour, Poor: < 30 minutes.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Lateral Lumbar Stenosis

Laminotomy

101

132

Trials Examining Surgical Patients with Central or Lateral Lumbar Stenosis (type of stenosis unspecified or includes both types of stenosis)

Study Design:	Controlled Trial
Authors and Year:	Yone and Sakou, 1999
Reporting:	Physician-reported
Method:	JOA score

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Mixed Stenosis with instability

Laminotomy

0.6

1.7

Mixed Stenosis with instability

Laminotomy with Fusion and Instrumentation

0.7

2.5

Mixed Stenosis without instability

Laminotomy

0.9

2.6

Authors and Year:	Javid and Hadar, 1998
Reporting:	Patient-reported
Method:	5 levels. Ex: Much better, Gd: Somewhat better, Fr: no different, Pr: Somewhat worse, VPr: Much worse.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

57.2

132

Central Lumbar Stenosis and Herniated Disk

SWDL-Standard Wide Decompressive Laminectomy

56.6

132

Lateral Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

86.6

132

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Katz, Lipson, Larson et al., 1991
Reporting:	Patient-reported
Method:	6 levels. 1: more than 3 km, 2: more than 2km, 3: 2 blocks to 2km, 4: less than 2 blocks but more than 15 m, 5: less than 15m, 6: bed-bound

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Mixed Stenosis

Mixed Decompression Techniques

Study Design:	Case-series
Authors and Year:	Mackay and Wheelwright, 1998
Reporting:	Patient-reported
Method:	Claudication Yes or no, pre and post

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Mixed Stenosis

Partial laminectomy or hemilaminectomy

Authors and Year:	Katz, Lipson, Chang et al., 1996
Reporting:	Patient-reported
Method:	4 Levels: Over 1 mile, 2 blocks to 1 mile, 50 feet to 2 blocks, less than 50 feet.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Degenerative Stenosis

SWDL-Standard Wide Decompressive Laminectomy

120

Authors and Year:	Fast, Robin, and Floman, 1985
Reporting:	Patient-reported
Method:	Stated that claudication was relieved by surgery in all but 1 patient.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Authors and Year:	Hood and Weigl, 1983
Reporting:	Patient-reported
Method:	2 levels: Distance improved or not

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Trials Examining Surgical Patients with Degenerative Spondylolisthesis

Study Design:	Randomized Controlled Trial
Authors and Year:	Bridwell, Sedgewick, O'Brien et al., 1993
Reporting:	Patient-reported
Method:	3 levels. Patients were asked if the surgery had improved (+), not changed (0), or worsened (-) their ability to walk.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

Partial laminectomy or hemilaminectomy

Degenerative Spondylolisthesis

Partial laminectomy and fusion

Degenerative Spondylolisthesis

Partial laminectomy with fusion and instrumentation

Study Design:	Controlled Trial
Authors and Year:	Satomi, Hirabayashi, Toyama et al., 1992
Reporting:	Patient-reported
Method:	JOA score 0 (severe pain)-3 (no pain)

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

Fusion and instrumentation

1.6

2.7

Degenerative Spondylolisthesis

Mixed Decompression Techniques

2.3

Study Design:	Retrospective Trial with Consecutive Patients
Authors and Year:	Nishizawa and Fujimura, 1997
Reporting:	Patient-reported
Method:	JOA score: 0 (Unable to walk) to 3 (Normal walking)

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

Fusion and instrumentation

1.2

128

2.8

Authors and Year:	Takahashi, Kitahara, Yamagata et al., 1990
Reporting:	Physician-reported
Method:	Presence or absence of neurogenic claudication

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

Fusion

151

360

Authors and Year:	Knox, Harvell, Nelson et al., 1989
Reporting:	Patient-reported
Method:	Number of blocks walked and Pain Scale of 0 (none) to 10 (severe)

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

1.1

21.3

6.8

Study Design:	Case-series
Authors and Year:	Grob, Humke, and Dvorak, 1996
Reporting:	Patient-reported
Method:	Distance that could be walked was measured

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Degenerative/spondylolytic Spondylolisthesis

SWDL with Fusion and Instrumentation

Trials Examining Surgical Patients with Lumbar Stenosis and/or Degenerative Spondylolisthesis

Study Design:	Controlled Trial
Authors and Year:	Rompe, Eysel, Zollner et al., 1999
Reporting:	Patient-reported
Method:	Patients rated walking capacity from 1 (best) to 5 (worst)

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

3.6

88.8

2.4

0.9

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

3.5

1.1

2.8

0.7

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

3.5

0.8

88.8

2.4

0.9

Authors and Year:	Katz, Lipson, Lew et al., 1997
Reporting:	Patient-reported
Method:	Scale of 1 to 5 with 1 being no difficulty and 5 being very severe difficulty.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

194

Mixed Stenosis / Sponsylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

194

3.5

0.7

2.5

2.6

Mixed Stenosis and Spondylolisthesis

SWDL with Fusion (Arthrodesis)

3.6

0.6

2.1

2.2

Mixed Stenosis and Spondylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

3.7

0.6

2.6

2.5

Study Design:	Prospective Trial
Authors and Year:	Jonsson, Annertz, Sjoberg et al., 1997a
Reporting:	Patient-reported
Method:	Patients reported ability to walk (<0.5 km, 0.5-1 km, 1-5 km, >5 km)

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

105

Central Spinal Stenosis and Degenerative Spondylolisthesis

Partial laminectomy or hemilaminectomy

Trials Examining Surgical Patients and Patients Receiving Conservative Treatment

Patient Condition:	Central lumbar stenosis
Study Design:	Controlled Trial
Authors and Year:	Simotas, Dorey, Hansraj, et al., 2000
Reporting:	Patient-reported
Method:	3 levels. Good: more than 10 blocks (200 ft per block), Fair: 2 to 10 blocks, Poor: less than 2 blocks

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

Conservative-various treatments

Central Lumbar Stenosis

Surgery - not described

Authors and Year:	Mariconda, Zanforlino, Celestino et al., 2000
Reporting:	Patient-reported
Method:	0, 1, 2, 3 scale: 0-only able to walk <100 m, 1-able to walk 100-500 m, 2- can walk >500 m, 3- no restriction in walking

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

0.6

2.2

1.2

Central Lumbar Stenosis

Control/Placebo/None

0.9

0.8

2.1

0.8

2.1

Authors and Year:	Johnsson, Uden, and Rosen, 1991
Reporting:	Patient-reported
Method:	Two measurements are reported. A subjective assessment in meters before onset of symptoms and based on a 0-100 visual analog scale where Poor (Worse), Fair (Unchanged), and Good (Improved) were 0-45, 46-55, and 56-1000.

Patient Group #:

N at start of trial

Specific Disorder:

Treatment:

Time in Months

Score

Rating Category

Mean

Min.

Max.

Mean

Central Lumbar Stenosis

Conservative-not described

1355

3081

2342

4069

Central Lumbar Stenosis - moderate stenosis

SWDL-Standard Wide Decompressive Laminectomy

186

203

109

1453

2935

Central Lumbar Stenosis - severe stenosis

SWDL-Standard Wide Decompressive Laminectomy

120

114

120

2373

4142

Evidence Table 23. Spinal Canal Measurements Related to Low Back Pain and Lumbar Spinal Stenosis All measurements are in millimeters

Patient Condition Back ache

Authors and Year:	Drinkall, Porter, Hibbert et al., 1984
Study Design	Case-series
Imaging Method for Diameter	Ultrasound
Imaging Method for Cross-section
Imaging Method for Ratio

Patient Group #

Specific Disorder:

Treatment:

Canal Diameter

Canal Cross Section

Canal Ratio

132

Healthy Control

Control/Placebo/None

Mean	14.4
SD	0.07

Mean
SD

193

Back Pain

Control/Placebo/None

Mean	14.1
SD	0.07

Mean
SD

Patient Condition Back Pain

Authors and Year:	Uden, Johnsson, Jonsson et al., 1985
Study Design	Case-series
Imaging Method for Diameter	X-ray Myelography
Imaging Method for Cross-section
Imaging Method for Ratio

Patient Group #

Specific Disorder:

Treatment:

Canal Diameter

Canal Cross Section

Canal Ratio

Control

Control/Placebo/None

Mean	14.9
SD	4.1

Mean
SD

Atypical symptoms

Control/Placebo/None

Mean	15.6
SD	3.8

Mean
SD

Sciatic pain

Control/Placebo/None

Mean	13.3
SD	4.1

Mean
SD

Suspicion of claudication

Control/Placebo/None

Mean	13
SD	4.6

Mean
SD

Spinal Claudication

Control/Placebo/None

Mean	9.8
SD	5.7

Mean
SD

Patient Condition Central lumbar stenosis

Authors and Year:	Mariconda, Zanforlino, Celestino et al., 2000
Study Design	Controlled Trial
Imaging Method for Diameter
Imaging Method for Cross-section	Computed Tomography (CT)
Imaging Method for Ratio

Patient Group #

Specific Disorder:

Treatment:

Canal Diameter

Canal Cross Section

Canal Ratio

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Mean
SD

Mean	68
SD

Mean
SD

Central Lumbar Stenosis

Control/Placebo/None

Mean	78
SD

Mean
SD

Authors and Year:	Herno, Partanen, Talaslahti et al., 1999
Study Design	Controlled Trial
Imaging Method for Diameter
Imaging Method for Cross-section	Magnetic Resonance Imaging (MRI)
Imaging Method for Ratio

Patient Group #

Specific Disorder:

Treatment:

Canal Diameter

Canal Cross Section

Canal Ratio

Central Lumbar Stenosis - post surgery stenosis

SWDL-Standard Wide Decompressive Laminectomy

Mean
SD

Mean	95
SD

Mean
SD

Central Lumbar Stenosis - no post surgery stenosis

SWDL-Standard Wide Decompressive Laminectomy

Mean
SD

Mean	145
SD

Mean
SD

Authors and Year:	Prasarirha, Suntisathaporn, Vathana et al., 1997
Study Design	Case-series
Imaging Method for Diameter	Plain X-ray
Imaging Method for Cross-section
Imaging Method for Ratio

Patient Group #

Specific Disorder:

Treatment:

Canal Diameter

Canal Cross Section

Canal Ratio

Healthy Control

Control/Placebo/None

Mean	15.67
SD
Mean	8.5
SD	2.6

Mean
SD
Mean
SD

Degenerative Spondylolisthesis

Pretreatment data only

Mean	13.88
SD
Mean	7.4
SD	2.9

Mean
SD
Mean
SD

Authors and Year:	Hamdan and Al-Kaissie, 1994
Study Design	Case-series
Imaging Method for Diameter
Imaging Method for Cross-section
Imaging Method for Ratio	Plain X-ray

Patient Group #

Specific Disorder:

Treatment:

Canal Diameter

Canal Cross Section

Canal Ratio

Central Lumbar Stenosis

Conservative

Mean
SD
Mean
SD

Mean
SD
Mean	61
SD	28

Mean
SD
Mean
SD

Low back pain only

Control/Placebo/None

Mean
SD
Mean
SD

Mean	130
SD	51
Mean
SD

Mean
SD
Mean
SD

Control (other conditions)

Control/Placebo/None

Mean
SD

Mean	144
SD	35

Mean
SD

Authors and Year:	Yoshida, Shima, Taniguchi et al., 1992
Study Design	Case-series
Imaging Method for Diameter
Imaging Method for Cross-section	Computed Tomography (CT)
Imaging Method for Ratio

Patient Group #

Specific Disorder:

Treatment:

Canal Diameter

Canal Cross Section

Canal Ratio

Control (herniated disk)

Control/Placebo/None

Mean
SD

Mean	356.7
SD	90.8

Mean
SD

Central Lumbar Stenosis

Pretreatment data only

Mean
SD

Mean	262.8
SD	62.8

Mean
SD

Authors and Year:	Johnsson, Uden, and Rosen, 1991
Study Design	Controlled Trial
Imaging Method for Diameter	X-ray Myelography
Imaging Method for Cross-section
Imaging Method for Ratio

Patient Group #

Specific Disorder:

Treatment:

Canal Diameter

Canal Cross Section

Canal Ratio

Central Lumbar Stenosis

Conservative-not described

Mean	8.6
SD	1.7

Mean
SD

Central Lumbar Stenosis - moderate stenosis

SWDL-Standard Wide Decompressive Laminectomy

Mean	7.9
SD	2.3

Mean
SD

Central Lumbar Stenosis - severe stenosis

SWDL-Standard Wide Decompressive Laminectomy

Mean	0
SD	0

Mean
SD

Authors and Year:	Schonstrom, Bolender, and Spengler, 1985
Study Design	Case-series
Imaging Method for Diameter	Computed Tomography (CT)
Imaging Method for Cross-section	Computed Tomography (CT)
Imaging Method for Ratio

Patient Group #

Specific Disorder:

Treatment:

Canal Diameter

Canal Cross Section

Canal Ratio

Central Lumbar Stenosis

Control/Placebo/None

Mean	14.1
SD	2.7

Mean	233.9
SD	71.8

Mean
SD

Healthy Control

Control/Placebo/None

Mean	14.8
SD	3.1

Mean	178
SD	50

Mean
SD

Authors and Year:	Sandhu, Lakhanpal, and Gupta, 1976
Study Design	Case-series
Imaging Method for Diameter	Plain X-ray
Imaging Method for Cross-section
Imaging Method for Ratio	Plain X-ray

Patient Group #

Specific Disorder:

Treatment:

Canal Diameter

Canal Cross Section

Canal Ratio

Healthy Control

Control/Placebo/None

Mean	16
SD

Mean
SD

Mean	4.85
SD

Central Lumbar Stenosis

Control/Placebo/None

Mean
SD

Mean	6.73
SD

Authors and Year:	Jones and Thomson, 1968
Study Design	Case-series
Imaging Method for Diameter
Imaging Method for Cross-section
Imaging Method for Ratio	Plain X-ray

Patient Group #

Specific Disorder:

Treatment:

Canal Diameter

Canal Cross Section

Canal Ratio

Healthy Control

Control/Placebo/None

Mean
SD

Mean	3.06
SD

Central Lumbar Stenosis

Control/Placebo/None

Mean
SD

Mean	5
SD

Patient Condition Degenerative Spondylolisthesis

Authors and Year:	Kim and Lee, 1995
Study Design	Case-series
Imaging Method for Diameter	Plain X-ray
Imaging Method for Cross-section
Imaging Method for Ratio

Patient Group #

Specific Disorder:

Treatment:

Canal Diameter

Canal Cross Section

Canal Ratio

Healthy Control

Control/Placebo/None

Mean	20.3
SD	1.8

Mean
SD

Degenerative Spondylolisthesis

Pretreatment data only

Mean	19.2
SD	1.8

Mean
SD

Authors and Year:	Sato, Wakamatsu, Yoshizumi et al., 1989
Study Design	Controlled Trial
Imaging Method for Diameter	Plain X-ray
Imaging Method for Cross-section
Imaging Method for Ratio

Patient Group #

Specific Disorder:

Treatment:

Canal Diameter

Canal Cross Section

Canal Ratio

257

Low-back pain controls

Control/Placebo/None

Mean	21
SD	2.4
Mean
SD

Mean
SD
Mean
SD

Degenerative Spondylolisthesis

Control/Placebo/None

Mean	19.7
SD	1.5

Mean
SD

Patient Condition Lateral lumbar stenosis

Authors and Year:	Mikhael, Ciric, Tarkington et al., 1981
Study Design	Controlled Trial
Imaging Method for Diameter	Plain X-ray
Imaging Method for Cross-section
Imaging Method for Ratio

Patient Group #

Specific Disorder:

Treatment:

Canal Diameter

Canal Cross Section

Canal Ratio

Lateral Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Mean	3.6
SD	0.8

Mean
SD

Healthy Control

Control/Placebo/None

Mean	7
SD

Mean
SD

Patient Condition Low back pain

Authors and Year:	Anderson, Adcock, Chovil et al., 1988
Study Design	Controlled Trial
Imaging Method for Diameter	Ultrasound
Imaging Method for Cross-section
Imaging Method for Ratio

Patient Group #

Specific Disorder:

Treatment:

Canal Diameter

Canal Cross Section

Canal Ratio

Back Pain

Control/Placebo/None

Mean	16
SD	2.5

Mean
SD

Healthy Control

Control/Placebo/None

Mean	17.2
SD	2.3

Mean
SD

Patient Condition Mixed lumbar stenosis

Authors and Year:	Spetzger, Bertalanffy, Reinges et al., 1997
Study Design	Case-series
Imaging Method for Diameter	Computed Tomography (CT)
Imaging Method for Cross-section	Computed Tomography (CT)
Imaging Method for Ratio

Patient Group #

Specific Disorder:

Treatment:

Canal Diameter

Canal Cross Section

Canal Ratio

Mixed Stenosis

Laminotomy

Mean	11.6
SD

Mean	60.1
SD

Mean
SD

Patient Condition None

Authors and Year:	Hultman, Saraste, and Ohlsen, 1992
Study Design	Case-series
Imaging Method for Diameter	Computed Tomography (CT)
Imaging Method for Cross-section	Computed Tomography (CT)
Imaging Method for Ratio

Patient Group #

Specific Disorder:

Treatment:

Canal Diameter

Canal Cross Section

Canal Ratio

Healthy Control

Control/Placebo/None

Mean	15.9
SD	1.6

Mean	240.4
SD	42.8

Mean
SD

Recurrent Back Pain

Control/Placebo/None

Mean	15.6
SD	1.9

Mean	240.7
SD	48.8

Mean
SD

Chronic Back Pain

Control/Placebo/None

Mean	15.1
SD	1.9

Mean	231.4
SD	52.3

Mean
SD

Patient Condition Stenosis/Spondylolisthesis

Authors and Year:	Jonsson, Annertz, Sjoberg et al., 1997a
Study Design	Prospective Trial
Imaging Method for Diameter	X-ray Myelography
Imaging Method for Cross-section
Imaging Method for Ratio

Patient Group #

Specific Disorder:

Treatment:

Canal Diameter

Canal Cross Section

Canal Ratio

105

Central Spinal Stenosis and Degenerative Spondylolisthesis

Partial laminectomy or hemilaminectomy

Mean	6.8
SD

Mean
SD

Authors and Year:	Johnsson, Uden, and Rosen, 1992
Study Design	Case-series
Imaging Method for Diameter	X-ray Myelography
Imaging Method for Cross-section
Imaging Method for Ratio

Patient Group #

Specific Disorder:

Treatment:

Canal Diameter

Canal Cross Section

Canal Ratio

Spinal stenosis and spondylolisthesis

No treatment

Mean	7
SD	3

Mean
SD

Evidence Table 24. Complications of Surgery Related to Treatment of Lumbar Spinal Stenosis

Authors and Year	Booth, Bridwell, Eisenberg et al., 1999
Study Design	Case-series

Patient Group #

Specific Disorder:

Treatment:

Degenerative Spondylolisthesis

Partial laminectomy with fusion and instrumentation

Total Complications	1	Dural Tears	Thrombosis	Infection	1	Instability
Deaths		Fractures	Paraplegia	Incontinence		Collapsed Fusion
Neurological Disorder
Adverse Reaction

Authors and Year	Herno, Saari, Suomalainen et al., 1999
Study Design	Controlled Trial

Patient Group #

Specific Disorder:

Treatment:

Central Lumbar Stenosis - no post-surgery stenosis

Mixed Decompression Techniques

Total Complications	3	Dural Tears	Thrombosis	Infection	Instability
Deaths	0	Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction

Central Lumbar Stenosis - post surgery stenosis

Mixed Decompression Techniques

Total Complications	6	Dural Tears	Thrombosis	Infection	Instability
Deaths	0	Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction

Authors and Year	Nakai, Yoshizawa, and Kobayashi, 1999
Study Design	Prospective Trial

Patient Group #

Specific Disorder:

Treatment:

Degenerative Spondylolisthesis

Fusion only

Total Complications	3	Dural Tears	Thrombosis	Infection	Instability	3
Deaths	0	Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction

Authors and Year	Vitaz, Raque, Shields et al., 1999
Study Design	Retrospective Trial with Consecutive Patients

Patient Group #

Specific Disorder:

Treatment:

Central Lumbar Stenosis

Mixed Decompression Techniques

Total Complications	7	Dural Tears	Thrombosis	Infection	3	Instability
Deaths	0	Fractures	Paraplegia	Incontinence		Collapsed Fusion
Neurological Disorder
Adverse Reaction	4	Multiple serious complications

Authors and Year	Epstein, 1998b
Study Design	Case-series

Patient Group #

Specific Disorder:

Treatment:

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

Total Complications	1	Dural Tears	Thrombosis	Infection	Instability
Deaths		Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction	1	1 Patient required instrument removal for pain.

Authors and Year	Javid and Hadar, 1998
Study Design	Controlled Trial

Patient Group #

Specific Disorder:

Treatment:

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Total Complications	1	Dural Tears	1	Thrombosis	Infection	Instability
Deaths	0	Fractures		Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction

Central Lumbar Stenosis and Herniated Disk

SWDL-Standard Wide Decompressive Laminectomy

Total Complications	3	Dural Tears	1	Thrombosis	Infection	2	Instability
Deaths		Fractures		Paraplegia	Incontinence		Collapsed Fusion
Neurological Disorder
Adverse Reaction

Authors and Year	Kalbarczyk, Lukes, and Seiler, 1998
Study Design	Controlled Trial

Patient Group #

Specific Disorder:

Treatment:

3 groups

148

Mixed Stenosis

Partial laminectomy and fusion

Total Complications	11	Dural Tears	Thrombosis	4	Infection	Instability
Deaths	1	Fractures	Paraplegia		Incontinence	Collapsed Fusion
Neurological Disorder		Note: Complications were not separately reported for each treatment group. It is known that the death from thrombosis was in group 3.
Adverse Reaction	7	3 Cardiac disturbances, 2 TIAs, 1 urinary tract infection, 1 wound abscess.

Authors and Year	McCulloch, 1998
Study Design	Case-series

Patient Group #

Specific Disorder:

Treatment:

Degenerative Spondylolisthesis

Partial laminectomy and fusion

Total Complications	2	Dural Tears	Thrombosis	1	Infection	0	Instability
Deaths	0	Fractures	Paraplegia		Incontinence		Collapsed Fusion
Neurological Disorder		1 Minor myocardial infarct
Adverse Reaction

Authors and Year	Plotz and Benini, 1998
Study Design	Controlled Trial

Patient Group #

Specific Disorder:

Treatment:

Degenerative Spondylolisthesis

Decompressive Surgery without fusion

Total Complications	0	Dural Tears	Thrombosis	Infection	Instability
Deaths		Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction

Degenerative Spondylolisthesis

Decompressive Surgery with fusion and Translaminar Screw Fixation

Total Complications	0	Dural Tears	Thrombosis	Infection	Instability
Deaths		Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction

Degenerative Spondylolisthesis

Decompressive Surgery with fusion and AO Internal Fixator

Total Complications	8	Dural Tears	5	Thrombosis	Infection	3	Instability
Deaths		Fractures		Paraplegia	Incontinence		Collapsed Fusion
Neurological Disorder
Adverse Reaction

Authors and Year	Tsai, Yang, and Bray, 1998
Study Design	Case-series

Patient Group #

Specific Disorder:

Treatment:

Mixed Stenosis

Laminotomy

Total Complications	6	Dural Tears	1	Thrombosis	Infection	Instability
Deaths	0	Fractures		Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction		2 patients had urinary retention. 3 patients needed reoperation for recurrent symptoms.

Authors and Year	Whitecloud, Castro, Brinker et al., 1998
Study Design	Case-series

Patient Group #

Specific Disorder:

Treatment:

Mixed Stenosis

SWDL with Fusion and Instrumentation

Total Complications	30	Dural Tears	Thrombosis	0	Infection	2	Instability
Deaths		Fractures	Paraplegia		Incontinence		Collapsed Fusion
Neurological Disorder	4	Not described.
Adverse Reaction		1 venous puncture, 1 pneumothorax, 2 peritoneal rent, 1 abdominal hernia, 1 pulmonary embolism, etc.

Authors and Year	Airaksinen, Herno, Turunen et al., 1997
Study Design	Retrospective Trial with Consecutive Patients

Patient Group #

Specific Disorder:

Treatment:

497

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Total Complications	48	Dural Tears	13	Thrombosis	20	Infection	15	Instability
Deaths		Fractures		Paraplegia		Incontinence		Collapsed Fusion
Neurological Disorder
Adverse Reaction

Authors and Year	Fischgrund, Mackay, Herkowitz et al., 1997
Study Design	Randomized Controlled Trial

Patient Group #

Specific Disorder:

Treatment:

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

Total Complications	0	Dural Tears	Thrombosis	Infection	0	Instability
Deaths	0	Fractures	Paraplegia	Incontinence		Collapsed Fusion
Neurological Disorder	0
Adverse Reaction

Degenerative Spondylolisthesis

SWDL with Fusion (Arthrodesis)

Total Complications	0	Dural Tears	Thrombosis	Infection	0	Instability
Deaths	0	Fractures	Paraplegia	Incontinence		Collapsed Fusion
Neurological Disorder	0
Adverse Reaction

Authors and Year	Spetzger, Bertalanffy, Reinges et al., 1997
Study Design	Case-series

Patient Group #

Specific Disorder:

Treatment:

Mixed Stenosis

Laminotomy

Total Complications	3	Dural Tears	1	Thrombosis	1	Infection	1	Instability
Deaths	0	Fractures		Paraplegia		Incontinence		Collapsed Fusion
Neurological Disorder
Adverse Reaction

Authors and Year	Thomas, Rea, Pikul et al., 1997
Study Design	Controlled Trial

Patient Group #

Specific Disorder:

Treatment:

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Total Complications	0	Dural Tears	0	Thrombosis	Infection	Instability
Deaths	0	Fractures		Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder	0
Adverse Reaction

Central Lumbar Stenosis

Laminotomy

Total Complications	2	Dural Tears	0	Thrombosis	Infection	Instability	0
Deaths	0	Fractures		Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder	0
Adverse Reaction	2	1 patient with pneumonia, 1 patient with urinary tract infection.

Authors and Year	Thomsen, Christensen, Eiskjaer et al., 1997
Study Design	Randomized Controlled Trial

Patient Group #

Specific Disorder:

Treatment:

Degenerative Spondylolisthesis

Partial laminectomy with fusion and instrumentation

Total Complications	1	Dural Tears	1	Thrombosis	Infection	Instability
Deaths	0	Fractures		Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction

Degenerative Spondylolisthesis

Partial laminectomy and fusion

Total Complications	0	Dural Tears	Thrombosis	Infection	Instability
Deaths	0	Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction

Authors and Year	Atlas, Deyo, Keller et al., 1996
Study Design	Controlled Trial

Patient Group #

Specific Disorder:

Treatment:

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Total Complications	10	Dural Tears	8	Thrombosis	Infection	Instability
Deaths	0	Fractures		Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder	2	1 neuropraxia and 1 hematoma
Adverse Reaction

Authors and Year	diPierro, Helm, Shaffrey et al., 1996
Study Design	Prospective Trial

Patient Group #

Specific Disorder:

Treatment:

Central Lumbar Stenosis

Partial laminectomy and fusion

Total Complications	4	Dural Tears	Thrombosis	Infection	2	Instability	0
Deaths	0	Fractures	Paraplegia	Incontinence		Collapsed Fusion
Neurological Disorder
Adverse Reaction	2	Cerebrospinal fluid leak

Authors and Year	Grob, Humke, and Dvorak, 1996
Study Design	Case-series

Patient Group #

Specific Disorder:

Treatment:

Degenerative/spondylolytic Spondylolisthesis

SWDL with Fusion and Instrumentation

Total Complications	3	Dural Tears	1	Thrombosis	Infection	Instability
Deaths		Fractures		Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder		1 Patient had a postoperative seroma requiring revision. One had a screw that was too long and had to be replaced.

Authors and Year	Ishac, Alhayek, Fournier et al., 1996
Study Design	Retrospective Trial with Consecutive Patients

Patient Group #

Specific Disorder:

Treatment:

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Total Complications	3	Dural Tears	Thrombosis		Infection	1	Instability
Deaths	0	Fractures	Paraplegia	1	Incontinence		Collapsed Fusion
Neurological Disorder	1	Foot drop
Adverse Reaction

Authors and Year	Rechtine, Sutterlin, Wood et al., 1996
Study Design	Prospective Trial

Patient Group #

Specific Disorder:

Treatment:

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

Total Complications	4	Dural Tears	3	Thrombosis		Infection	0	Instability
Deaths	0	Fractures	0	Paraplegia	0	Incontinence		Collapsed Fusion
Neurological Disorder	0
Adverse Reaction	1	"stripped screw"

Authors and Year	Sanderson and Getty, 1996
Study Design	Retrospective Trial with Consecutive Patients

Patient Group #

Specific Disorder:

Treatment:

Lateral Lumbar Stenosis

Laminotomy

Total Complications	6	Dural Tears	Thrombosis	4	Infection	2	Instability
Deaths	0	Fractures	Paraplegia	0	Incontinence		Collapsed Fusion
Neurological Disorder
Adverse Reaction

Authors and Year	Crock, Shiraishi, and Crock, 1995
Study Design	Retrospective Trial with Consecutive Patients

Patient Group #

Specific Disorder:

Treatment:

Mixed Stenosis

Partial laminectomy or hemilaminectomy

Total Complications		Dural Tears	1	Thrombosis	Infection	2	Instability	0
Deaths		Fractures		Paraplegia	Incontinence		Collapsed Fusion
Neurological Disorder	1	Unilateral foot drop.
Adverse Reaction

Authors and Year	Grob, Humke, and Dvorak, 1995
Study Design	Randomized Controlled Trial

Patient Group #

Specific Disorder:

Treatment:

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

Total Complications	2	Dural Tears	1	Thrombosis	Infection		Instability
Deaths	0	Fractures		Paraplegia	Incontinence	1	Collapsed Fusion
Neurological Disorder
Adverse Reaction

Central Lumbar Stenosis - single level

Partial laminectomy with fusion and instrumentation

Total Complications	3	Dural Tears	1	Thrombosis	Infection	Instability
Deaths	0	Fractures		Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction	2	Screws were removed because of persistent local pain.

Central Lumbar Stenosis - multiple segments

Partial laminectomy with fusion and instrumentation

Total Complications	4	Dural Tears	Thrombosis	Infection	Instability
Deaths	0	Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder	1	Diffuse motor weakness of the left lower limb.
Adverse Reaction	3	Loose internal fixator in one patient. Broken screws in two patients.

Authors and Year	Rompe, Eysel, Hopf et al., 1995
Study Design	Controlled Trial

Patient Group #

Specific Disorder:

Treatment:

Mixed Stenosis

SWDL with Fusion and Instrumentation

Total Complications	3	Dural Tears	2	Thrombosis	Infection	Instability	1
Deaths		Fractures		Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Total Complications	10	Dural Tears	8	Thrombosis	Infection	Instability
Deaths	1	Fractures		Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction	1	Pulmonary embolism

Mixed Stenosis and Spondylolisthesis

SWDL with Fusion and Instrumentation

Total Complications	2	Dural Tears	Thrombosis	Infection	Instability
Deaths		Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder	1	Paraparesis
Adverse Reaction	1	Persistent disturbance of wound healing

Authors and Year	Jonsson and Stromqvist, 1994
Study Design	Retrospective Trial with Consecutive Patients

Patient Group #

Specific Disorder:

Treatment:

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

Total Complications	3	Dural Tears	1	Thrombosis	Infection	1	Instability
Deaths	0	Fractures		Paraplegia	Incontinence		Collapsed Fusion
Neurological Disorder
Adverse Reaction	1	cauda equina syndrome

Authors and Year	Yuan, Garfin, Dickman et al., 1994
Study Design	Controlled Trial

Patient Group #

Specific Disorder:

Treatment:

2177

Degenerative Spondylolisthesis

Fusion and Pedical Screw Fixation

Total Complications	381	Dural Tears	161	Thrombosis	Infection	56	Instability
Deaths	0	Fractures	26	Paraplegia	Incontinence		Collapsed Fusion
Neurological Disorder	138	11 cord or root injury; 127 new radicular pain
Adverse Reaction

456

Degenerative Spondylolisthesis

Fusion

Total Complications	59	Dural Tears	26	Thrombosis	Infection	11	Instability
Deaths	0	Fractures	0	Paraplegia	Incontinence		Collapsed Fusion
Neurological Disorder	22	New radicular pain
Adverse Reaction

Authors and Year	Bridwell, Sedgewick, O'Brien et al., 1993
Study Design	Randomized Controlled Trial

Patient Group #

Specific Disorder:

Treatment:

Degenerative Spondylolisthesis

Partial laminectomy or hemilaminectomy

Total Complications	0	Dural Tears	Thrombosis	Infection	Instability
Deaths	0	Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder	0	No peripheral neurologic deficits.
Adverse Reaction

Degenerative Spondylolisthesis

Partial laminectomy and fusion

Total Complications	1	Dural Tears	Thrombosis	Infection	Instability
Deaths	0	Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder	0	No peripheral neurologic deficits.
Adverse Reaction	1	Postoperative cerebrovascular accident.

Degenerative Spondylolisthesis

Partial laminectomy with fusion and instrumentation

Total Complications	3	Dural Tears	1	Thrombosis	Infection	1	Instability
Deaths	0	Fractures		Paraplegia	Incontinence		Collapsed Fusion
Neurological Disorder	0	No peripheral neurologic deficits.
Adverse Reaction	1	One patient with poor lateral screw placement

Authors and Year	Postacchini, Cinotti, Perugia et al., 1993
Study Design	Controlled Trial

Patient Group #

Specific Disorder:

Treatment:

Congenital or Degenerative Stenosis, Combined, or Deg. Spondylolisthesis

Laminotomy

Total Complications	3	Dural Tears	Thrombosis	Infection	Instability	4
Deaths	0	Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder	3	Moderate to complete deficit of a single nerve root.
Adverse Reaction

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Total Complications	1	Dural Tears	Thrombosis	Infection	Instability	2
Deaths	0	Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder	1	Increase in a preoperative deficit of the L5 root
Adverse Reaction

Authors and Year	Silvers, Lewis, and Asch, 1993
Study Design	Retrospective Trial with Consecutive Patients

Patient Group #

Specific Disorder:

Treatment:

248

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Total Complications	57	Dural Tears	32	Thrombosis	3	Infection	3	Instability
Deaths	2	Fractures		Paraplegia		Incontinence		Collapsed Fusion
Neurological Disorder	1	Severe paraparesis
Adverse Reaction

Authors and Year	Simmons and Simmons, 1992
Study Design	Case-series

Patient Group #

Specific Disorder:

Treatment:

Mixed Stenosis

SWDL with Fusion and Instrumentation

Total Complications	8	Dural Tears	Thrombosis	Infection	1	Instability
Deaths	0	Fractures	Paraplegia	Incontinence		Collapsed Fusion
Neurological Disorder	3	2 paresthesia, 1 extensor hallucis longus weakness
Adverse Reaction	4	1 wound edge necrosis, 1 myocardial infarction, 2 urinary tract infections

Authors and Year	Marchesi, Thalgott, and Aebi, 1991
Study Design	Retrospective Trial with Consecutive Patients

Patient Group #

Specific Disorder:

Treatment:

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

Total Complications	1	Dural Tears	Thrombosis	Infection	1	Instability
Deaths	0	Fractures	Paraplegia	Incontinence		Collapsed Fusion
Neurological Disorder
Adverse Reaction

Authors and Year	Chang and McAfee, 1989
Study Design	Case-series

Patient Group #

Specific Disorder:

Treatment:

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

Total Complications	5	Dural Tears	Thrombosis	Infection	Instability
Deaths		Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction	5	5 urinary tract infections

Authors and Year	Herron and Trippi, 1989
Study Design	Case-series

Patient Group #

Specific Disorder:

Treatment:

Degenerative Spondylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

Total Complications	2	Dural Tears	Thrombosis	Infection	Instability
Deaths		Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction	2	1 intraoperative cardiac pacemaker malfunction, 1 postoperative acute ethanol withdrawal.

Authors and Year	Johnsson, Redlund-Johnell, Uden et al., 1989
Study Design	Case-series

Patient Group #

Specific Disorder:

Treatment:

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Total Complications		Dural Tears	Thrombosis	Infection	Instability
Deaths	1	Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction		One patient died of sepsis shortly after the operation.

Authors and Year	Knox, Harvell, Nelson et al., 1989
Study Design	Retrospective Trial with Consecutive Patients

Patient Group #

Specific Disorder:

Treatment:

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

Total Complications	4	Dural Tears	1	Thrombosis	Infection	Instability
Deaths	0	Fractures		Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction	3	1 wound dehiscence, 1 iliac crest bone graft site infection, 1 upper gastrointestinal bleed

Authors and Year	Mauersberger and Nietgen, 1989
Study Design	Case-series

Patient Group #

Specific Disorder:

Treatment:

Mixed Stenosis

Decompressive surgery with or without fusion

Total Complications	Dural Tears	Thrombosis	Infection	1	Instability
Deaths	Fractures	Paraplegia	Incontinence	1	Collapsed Fusion
Neurological Disorder
Adverse Reaction	The pt with postop incontinence required further surgery for resection of another lumbar segment.

Authors and Year	Nasca, 1989
Study Design	Controlled Trial

Patient Group #

Specific Disorder:

Treatment:

Lateral Lumbar Stenosis

Decompressive Surgery

Total Complications	2	Dural Tears	Thrombosis	Infection	Instability
Deaths		Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction		2 patients required fusion 1 and 3 years later.

Mixed Stenosis with instability

Decompressive Surgery with fusion and instrumentation

Total Complications	4	Dural Tears	1	Thrombosis	Infection		Instability
Deaths		Fractures		Paraplegia	Incontinence	1	Collapsed Fusion
Neurological Disorder
Adverse Reaction	2	2 postop hematomas

Degenerative Stenosis and scoliosis

Decompressive Surgery with fusion and instrumentation

Total Complications	3	Dural Tears	Thrombosis	Infection	Instability	1
Deaths		Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction	2	1 wound dishescence, 1 diffuse-intravascular coagulopathy

Authors and Year	Young, Veerapen, and O'Laoire, 1988
Study Design	Case-series

Patient Group #

Specific Disorder:

Treatment:

Central Lumbar Stenosis

Decompressive Surgery

Total Complications	9	Dural Tears	3	Thrombosis	Infection	3	Instability
Deaths		Fractures		Paraplegia	Incontinence		Collapsed Fusion
Neurological Disorder		1 pseudomeningocele, 1 root damage
Adverse Reaction		1 hematoma

Authors and Year	Lee and deBari, 1986
Study Design	Randomized Controlled Trial

Patient Group #

Specific Disorder:

Treatment:

Lateral Lumbar Stenosis

SWDL with Fusion (Arthrodesis)

Total Complications	0	Dural Tears	Thrombosis	Infection	Instability
Deaths	0	Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction

Lateral Lumbar Stenosis

SWDL with Fusion and Instrumentation

Total Complications	5	Dural Tears	Thrombosis	Infection	Instability
Deaths	0	Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction	5	5 patients with Knodt rods had subsequent operations to remove the rods due to local irritation.

Authors and Year	Hall, Bartleson, Onofrio et al., 1985
Study Design	Case-series

Patient Group #

Specific Disorder:

Treatment:

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Total Complications		Dural Tears	Thrombosis	Infection	Instability
Deaths	1	Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction

Authors and Year	Rosomoff, 1981
Study Design	Retrospective Trial with Consecutive Patients

Patient Group #

Specific Disorder:

Treatment:

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Total Complications	7	Dural Tears	Thrombosis	Infection	6	Instability	1
Deaths	0	Fractures	Paraplegia	Incontinence		Collapsed Fusion
Neurological Disorder
Adverse Reaction

Authors and Year	Scafuri and Weinstein, 1981
Study Design	Case-series

Patient Group #

Specific Disorder:

Treatment:

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Total Complications	3	Dural Tears	1	Thrombosis	Infection	Instability
Deaths	0	Fractures		Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction	2	1 patient with urinary tract infection. 1 patient with dural cutaneous fistula.

Authors and Year	Weir and De Leo, 1981
Study Design	Case-series

Patient Group #

Specific Disorder:

Treatment:

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Total Complications	9	Dural Tears	Thrombosis	0	Infection	1	Instability
Deaths	0	Fractures	Paraplegia		Incontinence	2	Collapsed Fusion
Neurological Disorder	4	3 transient neurologic deficit, 1 permanent increase in neurological deficit
Adverse Reaction	2	pulmonary complications

Authors and Year	Getty, 1980
Study Design	Retrospective Trial with Consecutive Patients

Patient Group #

Specific Disorder:

Treatment:

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Total Complications	12	Dural Tears	Thrombosis	4	Infection	2	Instability
Deaths		Fractures	Paraplegia		Incontinence	6	Collapsed Fusion
Neurological Disorder
Adverse Reaction

Authors and Year	Reale, Deifini, Gambacona et al., 1978
Study Design	Retrospective Trial with Consecutive Patients

Patient Group #

Specific Disorder:

Treatment:

Congenital Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Total Complications	5	Dural Tears	Thrombosis	Infection	2	Instability
Deaths	0	Fractures	Paraplegia	Incontinence		Collapsed Fusion
Neurological Disorder
Adverse Reaction	3	2 epiduritis, 1 spondylitis

Authors and Year	Choudhury and Taylor, 1977
Study Design	Case-series

Patient Group #

Specific Disorder:

Treatment:

Lateral Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Total Complications	8	Dural Tears	1	Thrombosis	1	Infection	Instability
Deaths	0	Fractures		Paraplegia		Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction	6	6 patients had temporary urinary retention, requiring catheterization for 12-48 hours.

Authors and Year	Verbiest, 1977
Study Design	Retrospective Trial with Consecutive Patients

Patient Group #

Specific Disorder:

Treatment:

116

Congenital Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Total Complications	8	Dural Tears	Thrombosis	1	Infection	Instability	0
Deaths	1	Fractures	Paraplegia		Incontinence	Collapsed Fusion
Neurological Disorder	7	Radicular deficits characterized as 3 bilateral peroneal weakness, 2 disturbance of micturition, and 2 increase in bilateral sensory deficit.
Adverse Reaction

Authors and Year	Vestad and Naca, 1977
Study Design	Case-series

Patient Group #

Specific Disorder:

Treatment:

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Total Complications	2	Dural Tears	Thrombosis	Infection	2	Instability
Deaths		Fractures	Paraplegia	Incontinence		Collapsed Fusion
Neurological Disorder
Adverse Reaction

Authors and Year	Fitzgerald and Newman, 1976
Study Design	Controlled Trial

Patient Group #

Specific Disorder:

Treatment:

Degenerative Spondylolisthesis

Mixed Decompression Techniques

Total Complications	2	Dural Tears	Thrombosis	Infection	Instability	2
Deaths		Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction

Authors and Year	Paine, 1976
Study Design	Controlled Trial

Patient Group #

Specific Disorder:

Treatment:

Degenerative Stenosis

SWDL-Standard Wide Decompressive Laminectomy

Total Complications	8	Dural Tears	Thrombosis	1	Infection	2	Instability
Deaths	1	Fractures	Paraplegia		Incontinence		Collapsed Fusion
Neurological Disorder	2	Increased cauda equina lesion. Complications reported for all 457 patients, not just the 95 with LSS. Length of FU not correctly reported.
Adverse Reaction	3	2 pulmonary embolus, on fatal. 1 postoperative hemorrhage.

Authors and Year	Rosenberg, 1976
Study Design	Controlled Trial

Patient Group #

Specific Disorder:

Treatment:

Degenerative Spondylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

Total Complications	5	Dural Tears	Thrombosis	Infection	Instability	5
Deaths	0	Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction

Authors and Year	Tile, McNeil, Zarins et al., 1976
Study Design	Controlled Trial

Patient Group #

Specific Disorder:

Treatment:

Mixed Stenosis

Mixed Decompression Techniques

Total Complications	7	Dural Tears	Thrombosis	Infection	Instability	7
Deaths	0	Fractures	Paraplegia	Incontinence	Collapsed Fusion
Neurological Disorder
Adverse Reaction

Evidence Table 25. Reported Co-morbidities of Patients with Lumbar Spinal Stenosis

Patient Condition:

Backache

Authors and Year:

Splithoff, 1953

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

100

Healthy Control

Control/Placebo/None

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	0
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity	30
Spondylolisthesis n=8, Osteoarthritis of the lumbosacral junction n=22

100

Backache

Control/Placebo/None

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity
Spondylolisthesis n=2, Osteoarthritis of the lumbosacral junction n=26.

Patient Condition:

Central lumbar stenosis

Authors and Year:

Kleeman, Hiscoe, and Berg, 2000

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

No Reported Comorbidities
Liver		Hypertension		Neurological
Kidney		Hip		Pulmonary	14
Heart	36	Knee		Herniated Disk
Diabetes	6	Arthritis	4	Degenerative Spine	15
Other Comorbidities Osteoporosis	19

Authors and Year:

Herno, Partanen, Talaslahti et al., 1999

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Central Lumbar Stenosis - post surgery stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity	15
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity
Only the number of patients with co-existing diseases was reported.

Central Lumbar Stenosis - no post surgery stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity	6
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity
Only the number of patients with co-existing diseases was reported.

Authors and Year:

Herno, Saari, Suomalainen et al., 1999

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Central Lumbar Stenosis - no postsurgery stenosis

Mixed Decompression Techniques

No Reported Comorbidity	18
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity
Comorbidity were reported as a total number and not defined.

Central Lumbar Stenosis - post surgery stenosis

Mixed Decompression Techniques

No Reported Comorbidity	38
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity
Comorbidity were reported as a total number and not defined.

Authors and Year:

Vitaz, Raque, Shields et al., 1999

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Central Lumbar Stenosis

Mixed Decompression Techniques

No Reported Comorbidity
Liver		Hypertension	37	Neurological
Kidney		Hip		Pulmonary	7
Heart	37	Knee		Herniated Disk	33
Diabetes	11	Arthritis		Degenerative Spine
Other Comorbidity hypothyroid	11

Authors and Year:

Airaksinen, Herno, Turunen et al., 1997

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

497

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity	255
Liver		Hypertension		Neurological	35
Kidney		Hip	12	Pulmonary	17
Heart	38	Knee	21	Herniated Disk
Diabetes	13	Arthritis	8	Degenerative Spine
Other Comorbidity hypothyroid	35
35 patients not described.

Authors and Year:

Matsui, Kanamori, Ishihara et al., 1997

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Central Lumbar Stenosis

SWDL with Fusion (Arthrodesis)

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart		Knee	Herniated Disk	7
Diabetes		Arthritis	Degenerative Spine
Other Comorbidity	5
Spondylolisthesis

Authors and Year:

Thomas, Rea, Pikul et al., 1997

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver		Hypertension		Neurological	1
Kidney		Hip	1	Pulmonary
Heart	1	Knee		Herniated Disk
Diabetes		Arthritis		Degenerative Spine
Other Comorbidity

Central Lumbar Stenosis

Laminotomy

No Reported Comorbidity
Liver		Hypertension	Neurological	3
Kidney		Hip	Pulmonary
Heart	1	Knee	Herniated Disk
Diabetes		Arthritis	Degenerative Spine
Other Comorbidity	1
Hypothyroid

Authors and Year:

diPierro, Helm, Shaffrey et al., 1996

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Central Lumbar Stenosis

Partial laminectomy and fusion

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk
Diabetes	Arthritis	Degenerative Spine	3
Other Comorbidity

Authors and Year:

Ishac, Alhayek, Fournier et al., 1996

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk
Diabetes	Arthritis	Degenerative Spine	1
Other Comorbidity

Authors and Year:

Grob, Humke, and Dvorak, 1995

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart	1	Knee	Herniated Disk	3
Diabetes		Arthritis	Degenerative Spine
Other Comorbidity

Central Lumbar Stenosis - single level

Partial laminectomy with fusion and instrumentation

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	6
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Central Lumbar Stenosis - multiple segments

Partial laminectomy with fusion and instrumentation

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	7
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Hamdan and Al-Kaissie, 1994

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Central Lumbar Stenosis

Conservative

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart		Knee	Herniated Disk
Diabetes		Arthritis	Degenerative Spine
Other Comorbidity	12
3 patients with spondylolisthesis, 9 patients with arthritis of the spine

Authors and Year:

Jonsson and Stromqvist, 1994

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Central Lumbar Stenosis

Partial laminectomy or hemilaminectomy

No Reported Comorbidity
Liver			Hypertension		Neurological	5
Kidney			Hip	5	Pulmonary
Heart	7		Knee	5	Herniated Disk
Diabetes			Arthritis		Degenerative Spine
Other Comorbidity		13
Spondylolisthesis

Authors and Year:

Caputy and Luessenhop, 1992

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

100

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver			Hypertension	29	Neurological	5
Kidney			Hip	5	Pulmonary
Heart	25		Knee	5	Herniated Disk	14
Diabetes	9		Arthritis		Degenerative Spine
Other Comorbidity		11
Hypothyroid

Authors and Year:

Yoshida, Shima, Taniguchi et al., 1992

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Control (herniated disk)

Control/Placebo/None

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	10
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Johnsson, Uden, and Rosen, 1991

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Central Lumbar Stenosis

Conservative-not described

No Reported Comorbidity
Liver			Hypertension	Neurological
Kidney			Hip	Pulmonary
Heart	2		Knee	Herniated Disk
Diabetes			Arthritis	Degenerative Spine
Other Comorbidity		5
Degenerative olisthesis

Central Lumbar Stenosis - severe stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart		Knee	Herniated Disk
Diabetes		Arthritis	Degenerative Spine
Other Comorbidity	7
Degenerative Olisthesis

Authors and Year:

Kurihara, Tanaka, Tsumura et al., 1988

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Hyperostotic stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk
Diabetes	Arthritis	Degenerative Spine	4
Other Comorbidity
At least 4 patients also had stenosis of the thoracic and/or cervical spine.

Authors and Year:

Schonstrom, Bolender, and Spengler, 1985

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Central Lumbar Stenosis

Control/Placebo/None

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	7
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Chahal, Mundkur, Sancheti et al., 1982

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	12
Diabetes	Arthritis	Degenerative Spine	19
Other Comorbidity

Authors and Year:

Johnsson, Willner, and Pettersson, 1981

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart		Knee	Herniated Disk
Diabetes		Arthritis	Degenerative Spine
Other Comorbidity	6
Spondylolisthesis

Authors and Year:

Weir and De Leo, 1981

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver		Hypertension	Neurological	67
Kidney		Hip	Pulmonary
Heart	17	Knee	Herniated Disk
Diabetes		Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Tajima, Fukazawa, and Ishio, 1980

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Central Lumbar Stenosis

Mixed Decompression Techniques

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	0
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Central Lumbar Stenosis and disk lesion

Mixed Decompression Techniques

No Reported Comorbidity	0
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	14
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Reale, Deifini, Gambacona et al., 1978

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Congenital Stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	12
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Verbiest, 1977

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

116

Congenital Stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	62
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Salibi, 1976

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart		Knee	Herniated Disk	16
Diabetes		Arthritis	Degenerative Spine
Other Comorbidity	1
Spondylolisthesis

Patient Condition:	Degenerative Spondylolisthesis
Authors and Year:	Booth, Bridwell, Eisenberg et al., 1999

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Degenerative Spondylolisthesis

Partial laminectomy with fusion and instrumentation

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity
Patients had an average of 2.7 +/- 1.8 comorbidity.

Authors and Year:

Epstein, 1998a

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

290

Mixed Stenosis

Mixed Decompression Techniques

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	59
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

McCulloch, 1998

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Degenerative Spondylolisthesis

Partial laminectomy and fusion

No Reported Comorbidity	19
Liver		Hypertension	Neurological	1
Kidney		Hip	Pulmonary
Heart	1	Knee	Herniated Disk
Diabetes		Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Yuan, Garfin, Dickman et al., 1994

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

2177

Degenerative Spondylolisthesis

Fusion and Pedical Screw Fixation

No Reported Comorbidity
Liver			Hypertension	Neurological
Kidney			Hip	Pulmonary
Heart			Knee	Herniated Disk
Diabetes	321		Arthritis	Degenerative Spine
Other Comorbidity		610
Osteoporosis

456

Degenerative Spondylolisthesis

Fusion

No Reported Comorbidity
Liver			Hypertension	Neurological
Kidney			Hip	Pulmonary
Heart			Knee	Herniated Disk
Diabetes	68		Arthritis	Degenerative Spine
Other Comorbidity		128
Osteoporosis

Authors and Year:

Marchesi, Thalgott, and Aebi, 1991

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart		Knee	Herniated Disk
Diabetes		Arthritis	Degenerative Spine
Other Comorbidity	8
Osteoporosis

Authors and Year:

Knox, Harvell, Nelson et al., 1989

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

No Reported Comorbidity
Liver			Hypertension		Neurological
Kidney			Hip		Pulmonary
Heart	2		Knee		Herniated Disk
Diabetes			Arthritis	11	Degenerative Spine
Other Comorbidity		1
rheumatoid arthritis

Authors and Year:

Inoue, Watanabe, Goto et al., 1988

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Degenerative Spondylolisthesis

Fusion

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	8
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Kaneda and Kazama, 1986

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Degenerative Spondylolisthesis

SWDL with Fusion and Instrumentation

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	8
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Alexander Jr, Kelly Jr, Davis Jr et al., 1985

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Degenerative Spondylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	7
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity
7 herniated disks, 11 protruding or bulging disks, 7 extruded disks.

Authors and Year:

Epstein, Epstein, Carras et al., 1983

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Degenerative Spondylolisthesis

Mixed Decompression Techniques

No Reported Comorbidity
Liver		Hypertension		Neurological	1
Kidney		Hip	12	Pulmonary
Heart	1	Knee	7	Herniated Disk	2
Diabetes	6	Arthritis	1	Degenerative Spine	1
Other Comorbidity	4
Hypothyroid

Authors and Year:

Rosenberg, 1976

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Degenerative Spondylolisthesis

Partial laminectomy or hemilaminectomy

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	4
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Patient Condition:

Lateral lumbar stenosis

Authors and Year:

Sanderson and Getty, 1996

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Lateral Lumbar Stenosis

Laminotomy

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	18
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Kirkaldy-Willis, Wedge, Yong-Hing et al., 1982

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Lateral Lumbar Stenosis with disk herniation

Partial laminectomy or hemilaminectomy

No Reported Comorbidity	0
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	32
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Lateral and Central Lumbar Stenosis with disk herniation

Partial laminectomy or hemilaminectomy

No Reported Comorbidity	0
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	21
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Mikhael, Ciric, Tarkington et al., 1981

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Lateral Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart		Knee	Herniated Disk	7
Diabetes		Arthritis	Degenerative Spine
Other Comorbidity	5
Degenerative spondylolisthesis

Authors and Year:

Choudhury and Taylor, 1977

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Lateral Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart		Knee	Herniated Disk	4
Diabetes		Arthritis	Degenerative Spine
Other Comorbidity bulging disks	5

Authors and Year:

Epstein, Epstein, Rosenthal et al., 1972

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Lateral Lumbar Stenosis

Foraminotomy/nerve root decompression

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	0
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Patient Condition:

Mixed lumbar stenosis

Authors and Year:

Guigui, Benoist, Delecourt et al., 1998

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Mixed Stenosis

Decompressive Surgery

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	23
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Javid and Hadar, 1998

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart		Knee	Herniated Disk	0
Diabetes		Arthritis	Degenerative Spine
Other Comorbidity	6
Degenerative Spondylolisthesis

Central Lumbar Stenosis and Herniated Disk

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	61
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Lateral Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	0
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Mackay and Wheelwright, 1998

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Mixed Stenosis

Partial laminectomy or hemilaminectomy

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	4
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Scholz, Firsching, and Lanksch, 1998

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Mixed Stenosis

Decompressive Surgery

No Reported Comorbidity
Liver		Hypertension		Neurological	5
Kidney		Hip	2	Pulmonary
Heart	3	Knee		Herniated Disk
Diabetes	9	Arthritis	1	Degenerative Spine
Other Comorbidity
3 cervical myelopathy, 3 cancer

Authors and Year:

Tsai, Yang, and Bray, 1998

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Mixed Stenosis

Laminotomy

No Reported Comorbidity		21
Liver		Hypertension	12	Neurological
Kidney		Hip		Pulmonary	3
Heart	5	Knee		Herniated Disk
Diabetes	4	Arthritis	11	Degenerative Spine
Other Comorbidity	2
Not described

Authors and Year:

Whitecloud, Castro, Brinker et al., 1998

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Mixed Stenosis

SWDL with Fusion and Instrumentation

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart		Knee	Herniated Disk	5
Diabetes		Arthritis	Degenerative Spine		10
Other Comorbidity	25
Either overweight or obese.

Authors and Year:

Spetzger, Bertalanffy, Reinges et al., 1997

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Mixed Stenosis

Laminotomy

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	2
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Atlas, Deyo, Keller et al., 1996

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity
60.5% of patients had self-reported chromic pulmonary disease, heart disease, stroke, cancer, or diabetes.

Mixed Stenosis

Conservative-many

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity
68.2% of patients had self-reported chromic pulmonary disease, heart disease, stroke, cancer, or diabetes.

Authors and Year:

Katz, Lipson, Chang et al., 1996

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Degenerative Stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver	Hypertension		Neurological
Kidney	Hip		Pulmonary
Heart	Knee		Herniated Disk
Diabetes	Arthritis	9	Degenerative Spine
Other Comorbidity

Authors and Year:

Crock, Shiraishi, and Crock, 1995

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Mixed Stenosis

Partial laminectomy or hemilaminectomy

No Reported Comorbidity
Liver			Hypertension	Neurological
Kidney			Hip	Pulmonary
Heart	5		Knee	Herniated Disk
Diabetes	1		Arthritis	Degenerative Spine
Other Comorbidity		11
5 patients with degenerative spondylolisthesis of 20% slippage.6 patients with scoliosis.

Authors and Year:

Lehto and Honkanen, 1995

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Mixed Stenosis

Decompressive Surgery

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart		Knee	Herniated Disk
Diabetes		Arthritis	Degenerative Spine
Other Comorbidity	61
61 patients were overweight (BMI>25)

Authors and Year:

Cinotti, Postacchini, and Weinstein, 1994

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Mixed Stenosis - diabetes

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart	5	Knee	Herniated Disk
Diabetes	25	Arthritis	Degenerative Spine
Other Comorbidity
Cumulative Illness Rating Scale with three classes: 5 patients with less than 2 patients; 6 patients with 3 to 5 points, and 14 patients with more than 6 points.

Mixed Stenosis - no diabetes

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart	1	Knee	Herniated Disk
Diabetes	0	Arthritis	Degenerative Spine
Other Comorbidity
Cumulative Illness Rating Scale with three classes: 7 patients with less than 2 patients; 9 patients with 3 to 5 points, and 9 patients with more than 6 points.

Authors and Year:

McCullen, Bernini, Bernstein et al., 1994

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

193

Mixed Stenosis

Decompressive Surgery

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart		Knee	Herniated Disk
Diabetes	19	Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Silvers, Lewis, and Asch, 1993

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

248

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart		Knee	Herniated Disk	42
Diabetes	13	Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Simpson, Silveri, Balderston et al., 1993

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Mixed Stenosis - diabetes

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity		0
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart		Knee	Herniated Disk
Diabetes	33	Arthritis	Degenerative Spine
Other Comorbidity

Mixed Stenosis - no diabetes

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart		Knee	Herniated Disk
Diabetes	0	Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Katz, Lipson, Larson et al., 1991

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Mixed Stenosis

Mixed Decompression Techniques

No Reported Comorbidity
Liver			Hypertension		Neurological
Kidney			Hip		Pulmonary	6
Heart	20		Knee		Herniated Disk
Diabetes			Arthritis	28	Degenerative Spine
Other Comorbidity		9
rheumatoid arthritis

Authors and Year:

Ganz, 1990

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	3
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Nasca, 1989

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Lateral Lumbar Stenosis

Decompressive Surgery

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart		Knee	Herniated Disk	4
Diabetes		Arthritis	Degenerative Spine
Other Comorbidity	4
4 patients had herniated disks.

Central-mixed Stenosis

Decompressive Surgery

No Reported Comorbidity
Liver	Hypertension		Neurological
Kidney	Hip		Pulmonary
Heart	Knee		Herniated Disk
Diabetes	Arthritis	1	Degenerative Spine
Other Comorbidity

Degenerative Stenosis and scoliosis

Decompressive Surgery with fusion and instrumentation

No Reported Comorbidity
Liver		Hypertension		Neurological
Kidney		Hip		Pulmonary
Heart		Knee	Herniated Disk
Diabetes		Arthritis	2	Degenerative Spine
Other Comorbidity	8
8 had osteoporosis

Authors and Year:

Fast, Robin, and Floman, 1985

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney	1	Hip	Pulmonary
Heart		Knee	Herniated Disk
Diabetes		Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Hood and Weigl, 1983

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Mixed Stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart	2	Knee	Herniated Disk
Diabetes	2	Arthritis	Degenerative Spine
Other Comorbidity
1 multiple arthroplasties, 1 peripheral vascular disease- this patient died and is not otherwise reported on.

Authors and Year:

Paine, 1976

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Degenerative stenosis with disk herniation

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	48
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Authors and Year:

Shenkin and Hash, 1976

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Mixed Stenosis - no prior surgery

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	0
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Mixed Stenosis - prior surgery for herniated disk

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	0
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Patient Condition:	Stenosis/Spondylolisthesis
Authors and Year:	Radu and Menkes, 1998

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Central Lumbar Stenosis

Conservative

No Reported Comorbidity		7
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart		Knee	Herniated Disk	14
Diabetes		Arthritis	Degenerative Spine
Other Comorbidity	38
20 Spondylolisthesis, 18 Scoliosis

Authors and Year:

Jonsson, Annertz, Sjoberg et al., 1997a

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

105

Central Spinal Stenosis and Degenerative Spondylolisthesis

Partial laminectomy or hemilaminectomy

No Reported Comorbidity		19
Liver		Hypertension		Neurological	5
Kidney		Hip	5	Pulmonary
Heart	3	Knee	6	Herniated Disk
Diabetes		Arthritis		Degenerative Spine
Other Comorbidity

Authors and Year:

Katz, Lipson, Lew et al., 1997

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

194

Mixed Stenosis / Sponsylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity
45 with spondylolisthesis, and 14 with scoliosis

Mixed Stenosis and Spondylolisthesis

SWDL with Fusion (Arthrodesis)

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity
26 with spondylolisthesis, and 1 with scoliosis

Mixed Stenosis and Spondylolisthesis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity
22 with spondylolisthesis, and 5 with scoliosis

Authors and Year:

Amundsen, Weber, Lilleas et al., 1995

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

100

Mixed Stenosis

Control/Placebo/None

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	9
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity
56 patients had scoliosis and 12 patients had degenerative spondylolisthesis.

Authors and Year:

Rompe, Eysel, Hopf et al., 1995

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Mixed Stenosis

SWDL with Fusion and Instrumentation

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart		Knee	Herniated Disk	14
Diabetes		Arthritis	Degenerative Spine
Other Comorbidity	3
Degenerative spondylolisthesis

Mixed Stenosis and Spondylolisthesis

SWDL with Fusion and Instrumentation

No Reported Comorbidity
Liver		Hypertension	Neurological
Kidney		Hip	Pulmonary
Heart		Knee	Herniated Disk
Diabetes		Arthritis	Degenerative Spine	3
Other Comorbidity	9
Degenerative spondylolisthesis

Authors and Year:

Postacchini, Cinotti, Perugia et al., 1993

Patient Group #

Specific Disorder

Treatment

Number of Patients with each Disease or Co-morbidity

Congenital or Degenerative Stenosis, Combined, or Deg. Spondylolisthesis

Laminotomy

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	0
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Central Lumbar Stenosis

SWDL-Standard Wide Decompressive Laminectomy

No Reported Comorbidity
Liver	Hypertension	Neurological
Kidney	Hip	Pulmonary
Heart	Knee	Herniated Disk	4
Diabetes	Arthritis	Degenerative Spine
Other Comorbidity

Bookshelf ID: NBK33618

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