Surgical outcome of lower limbs radiculopathy “due to degenerative lumbar canal stenosis” 12-24 months after decompression


  • Nashaddin Azeez Mohammed Department of Neurosurgery, Shar Hospital, As-Sulaymaniyah, Iraq.
  • Ari Sami Hussain Department of Neurosurgery, Shar Hospital, As-Sulaymaniyah, Iraq.



Lumbar canal stenosis, Radiculopathy, Neurovascular, Decompression


Objectives: Interlaminar decompression is a surgical procedure that decompresses the lumbar spinal canal in order to release neuro-vascular components that have been compromised by degenerative stenosis. It can significantly improve patient quality of life and reduce morbidity and the effects of lumbar canal stenosis.

Methods: A retrospective study of 57 patients, surgically operated for degenerative lumbar canal stenosis, at the Sulaymaniyah teaching hospital between Mar. 2018 and Mar. 2020.

Diagnosis was achieved via history and clinical examination and radiological imaging (Lumbo-sacral spine MRI).  Surgical procedure was standardized for all patients that was interlaminar decompression of the lumbar spinal canal, the postoperative follow up was after 12-24 months.

Results: In total, 57 patients with degenerative lumbar canal stenosis (due to ligamentum flavum hypertrophy) were included, male (26%) and female (74%), age of the cases were between 34 – 85 years, mean 57.39 and median 57 and standard deviation 10.96, there were no deference in the outcome of different ages and genders.

chief complain of patients were back pain and both lower limbs radiculopathy in the majority of the cases, associated with paresthesia and numbness of the lower limbs, which were improved modestly after surgical decompression.

Conclusion: Interlaminar decompression of the stenosed lumbar spinal canal is an effective and generally safe surgical procedure with high patient satisfaction and good functional outcomes expected.


- Dilip K. Sengupta, MD Harry N. Herkowitz, MD, Lumbar spinal stenosis Treatment strategies and indications for surgery. Orthop Clin N Am 34 (2003) 281 – 295.

- Sting M. Jesperson, Ebbe S. Hansen, Kristian Hoy, et al. Two-level spinal stenosis in minipigs: hemodynamic effects of exercise. Spine volume 20. Number 24, PP 2765-2773.

- Keisuke Takahashi, Kenji Kagechika, Tetsuya Takino, et al. Changes in epidural pressure during walking in patients with lumbar spinal stenosis. Spine Volume 20, Number 24, pp 2746-2749.

- Robert Gunzburg, Marek Szpalski, The conservative surgical treatment of lumbar spinal stenosis in the elderly. Eur Spine J (2003) 12 (Suppl. 2): S176–S180.

- J. N. BLAU, Valentine Logue. The natural history of intermittent claudication of the cauda equina a long-term follow-up study. brain (1978), 101, 211-222.

- Janan Abbas, Kamal Hamoud, Youssef M. Masharawi, et al. Ligamentum Flavum Thickness in Normal and Stenotic Lumbar Spines. SPINE Volume 35, Number 12, pp 1225–1230.

- Naime Altinkaya, Tulin Yildiri m, Senay Demir, et al. Factors Associated with the Thickness of the Ligamentum Flavum. SPINE Volume 36, Number 16, pp E1093–E1097.

- Avraam Ploumis, Ensor E. Transfledt, Francis Denis. Review Article Degenerative lumbar scoliosis associated with spinal stenosis. The Spine Journal 7, 428–436, 2007.

- L. Penning, J. T. Wilmink. Poster-dependent bilateral compression of L4 or L5 nerve roots in facet hypertrophy; a dynamic CT-myelography study. Spine. Volume 12. Number 5. 1987.

- Nikolai Bogduk, Clinical Anatomy of the Lumbar Spine and Sacrum. Fourth edition. pp 29-50. 2005.

- Ai-Min Wu, Fei Zou, Yong Cao, et al. Lumbar spinal stenosis: an update on the epidemiology, diagnosis and treatment. AME Medical Journal, 2017.

- James N. Weinstein, Tor D. Tosteson, Jon D. Lurie, et al. Surgical Versus Nonoperative Treatment for Lumbar Spinal Stenosis Four-Year Results of the Spine Patient Outcomes Research Trial. SPINE Volume 35, Number 14, pp 1329–1338, 2010.

- Steven J. Atlas, Robert B. Keller, Yen A. Wu, et al. Long-Term Outcomes of Surgical and Nonsurgical Management of Lumbar Spinal Stenosis: 8 to 10 Year Results from the Maine Lumbar Spine Study. SPINE Volume 30, Number 8, pp 936–943, 2005.

- Robert Gunzburg, Marek Szpalski, The conservative surgical treatment of lumbar spinal stenosis in the elderly. Eur Spine J (2003) 12 (Suppl. 2): S176–S180.

- Jeffrey N. Katz, and Mitchel B. Harris. Lumbar Spinal Stenosis. N Engl J Med; 358:818-25, 2008.

- Elisabeth Thornes, Nikolaos Ikonomou, and Margreth Grotle. Prognosis of Surgical Treatment for Degenerative Lumbar Spinal Stenosis: A Prospective Cohort Study of Clinical Outcomes and Health-Related Quality of Life Across Gender and Age Groups. Open Orthop J. 5: 372–378, 2011.

- Shay Shabat, Yoram Folman, Zeev Arinzon, et al. Gender differences as an influence on patients’ satisfaction rates in spinal surgery of elderly patients. Eur Spine J 14: 1027–1032, 2005.

- Martin N. Stienena, Holger Joswiga, Nicolas R. Smoll, et al. Short- and long-term effects of smoking on pain and health-related quality of life after non-instrumented lumbar spine surgery. Clinical Neurology and Neurosurgery 142, 87–92, 2016.

- Shaun Previn Appadurai, Patrick Lo. Effects of diabetes and smoking on lumbar spinal surgery outcomes. Journal of Clinical Neuroscience 20, 1713–1717, 2013.

- Kazuo Yamashita, Kenji Ohzono, MD, and Kazuo Hiroshima. Patient Satisfaction as an Outcome Measure After Surgical Treatment for Lumbar Spinal Stenosis: Testing the Validity and Discriminative Ability in Terms of Symptoms and Functional Status. SPINE Volume 31, Number 22, pp 2602–2608, 2006.

- Leslie C. L. Ng, Suhayl Tafazal, and Philip Sell. The effect of duration of symptoms on standard outcome measures in the surgical treatment of spinal stenosis. Eur Spine J 16: 199–206, 2007.

- R. Gepstein, S. Shabat, Z. H. Arinzon, et al. Does Obesity Affect the Results of Lumbar Decompressive Spinal Surgery in the Elderly? CLINICAL ORTHOPAEDICS AND RELATED RESEARCH Number 426, pp. 138–144, 2017.



How to Cite

Azeez Mohammed, N. ., & Sami Hussain, A. . (2023). Surgical outcome of lower limbs radiculopathy “due to degenerative lumbar canal stenosis” 12-24 months after decompression . Iraq Medical Journal, 7(1).