Clinical Research
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Year 2025, Volume: 7 Issue: 3, 584 - 90, 09.09.2025
https://doi.org/10.37990/medr.1647600

Abstract

References

  • Friedmann E. Narrowing of the spinal canal due to thickened lamina a cause of low-back pain and sciatica. Clin Orthop Relat Res. 1961;21:190-7.
  • Kwon J-w, Moon S-H, Park S-Y, et al. Lumbar spinal stenosis: review update 2022. Asian Spine J. 2022;16:789-98.
  • Katz JN, Zimmerman ZE, Mass H, Makhni MC. Diagnosis and management of lumbar spinal stenosis: a review. JAMA. 2022;327:1688-99.
  • Lee BH, Moon S-H, Suk K-S, et al. Lumbar spinal stenosis: pathophysiology and treatment principle: a narrative review. Asian Spine J. 2020;14:682-93.
  • Kozanek M, Wang S, Passias PG, et al. Range of motion and orientation of the lumbar facet joints in vivo. Spine. 2009;34:E689-96.
  • Le CK, Rauschning, W Gleen W. Lateral lumbar spinal canal stenosis: classification, pathologic anatomy and surgical decompression. Spine (Phila Pa 1976). 1988;13:313-20.
  • Jensen RK, Harhangi BS, Huygen F, Koes B. Lumbar spinal stenosis. BMJ. 2021;373:n1581.
  • Genevay S, Courvoisier DS, Konstantinou K, et al. Clinical classification criteria for neurogenic claudication caused by lumbar spinal stenosis. The N-CLASS criteria. Spine J. 2018;18:941-7.
  • Weinstein JN, Tosteson TD, Lurie JD, et al. Surgical versus nonoperative treatment for lumbar spinal stenosis four-year results of the Spine Patient Outcomes Research Trial. Spine (Phila Pa 1976). 2010;35:1329-38.
  • Kjaer P, Leboeuf-Yde C, Korsholm L, et al. Magnetic resonance imaging and low back pain in adults: a diagnostic imaging study of 40-year-old men and women. Spine (Phila Pa 1976). 2005;30:1173-80.
  • Lee SY, Kim T-H, Oh JK, et al. Lumbar stenosis: a recent update by review of literature. Asian Spine J. 2015;9:818-28.
  • Kim HJ, Yang JH, Chang D-G, et al. Impact of preoperative total knee arthroplasty on radiological and clinical outcomes of spinal fusion for concurrent knee osteoarthritis and degenerative lumbar spinal diseases. J Clin Med. 2021;10:4475.
  • McNamara MJ, Barrett KG, Christie MJ, Spengler DM. Lumbar spinal stenosis and lower extremity arthroplasty. J Arthroplasty. 1993;8:273-7.
  • Park J, Ham D-W, Kwon B-T, et al. Minimally invasive spine surgery: techniques, technologies, and indications. Asian Spine J. 2020;14:694-701.
  • Park S-M, Park J, Jang HS, et al. Biportal endoscopic versus microscopic lumbar decompressive laminectomy in patients with spinal stenosis: a randomized controlled trial. Spine J. 2020;20:156-65.
  • Yaldiz C, Ozkal B, Guvenc Y, et al. Comparison of the rigid rod system with modular plate with the finite element analysis in short-segment posterior stabilization in the lower lumbar region. Turk Neurosurg. 2017;27:610-6..
  • Yilmaz A, Senturk S, Sasani M, et al. Disc rehydration after dynamic stabilization: a report of 59 cases. Asian Spine J. 2017;11:348-55.
  • Kwon J-W, Lee BH, Lee S-B, et al. Hand grip strength can predict clinical outcomes and risk of falls after decompression and instrumented posterolateral fusion for lumbar spinal stenosis. Spine J. 2020;20:1960-7.
  • Lee BH, Kim T-H, Park M-S, et al. Comparison of effects of nonoperative treatment and decompression surgery on risk of patients with lumbar spinal stenosis falling: evaluation with functional mobility tests. J Bone Joint Surg Am. 2014;96:e110.
  • Tokuhashi Y, Matsuzaki H, Sano S. Evaluation of clinical lumbar instability using the treadmill. Spine (Phila Pa 1976). 1993;18:2321-4.
  • Johnsson K-E, Uden A, Rosén I. The effect of decompression on the natural course of spinal stenosis: a comparison of surgically treated and untreated patients. Spine (Phila Pa 1976). 1991;16:615-9.
  • Turner JA, Ersek M, Herron L, Deyo R. Surgery for lumbar spinal stenosis: attempted meta-analysis of the literature. Spine (Phila Pa 1976). 1992;17:1-8.
  • Herno A, Airaksinen O, Saari T. Long-term results of surgical treatment of lumbar spinal stenosis. Spine (Phila Pa 1976). 1993;18:1471-4.
  • Deen HG, Zimmerman RS, Swanson SK, Larson TR. Assessment of bladder function after lumbar decompressive laminectomy for spinal stenosis: a prospective study. J Neurosurg. 1994;80:971-4.
  • Tram J, Srinivas S, Wali AR, et al. Decompression surgery versus interspinous devices for lumbar spinal stenosis: a systematic review of the literature. Asian Spine J. 2020;14:526-42.
  • Zhang J, Liu T-F, Shan H, et al. Decompression using minimally invasive surgery for lumbar spinal stenosis associated with degenerative spondylolisthesis: a review. Pain Ther. 2021;10:941-59.
  • Försth P, Ólafsson G, Carlsson T, et al. A randomized, controlled trial of fusion surgery for lumbar spinal stenosis. N Engl J Med. 2016;374:1413-23.
  • Hermansen E, Austevoll IM, Hellum C, et al. Comparison of 3 different minimally invasive surgical techniques for lumbar spinal stenosis: a randomized clinical trial. JAMA Netw Open. 2022;5:e224291.
  • Ulrich NH, Burgstaller JM, Valeri F, et al. Incidence of revision surgery after decompression with vs without fusion among patients with degenerative lumbar spinal stenosis. JAMA Netw Open. 2022;5:e2223803.
  • Deen HG, Zimmerman RS, Lyons MK, et al. Measurement of exercise tolerance on the treadmill in patients with symptomatic lumbar spinal stenosis: a useful indicator of functional status and surgical outcome. J Neurosurg. 1995;83:27-30.
  • Deen HG, Zimmerman RS, Lyons MK, et al. Use of the exercise treadmill to measure baseline functional status and surgical outcome in patients with severe lumbar spinal stenosis. Spine (Phila Pa 1976). 1998;23:244-8.
  • Deen HG, Zimmerman RS, Lyons MK, et al. Test-retest reproducibility of the exercise treadmill examination in lumbar spinal stenosis. Mayo Clin Proc. 2000;75:1002-7.
  • McIlroy S, Jadhakhan F, Bell D, Rushton A. Prediction of walking ability following posterior decompression for lumbar spinal stenosis. Eur Spine J. 2021;30:3307-18.
  • Higuchi D, Kondo Y, Miki T. Patterns of physical activity and exercise after lumbar surgery among Japanese patients with lumbar spinal stenosis. J Phys Ther Sci. 2021;33:146-52.
  • Nakae I, Hashida R, Otsubo R, et al. Impact of spinal surgery on locomotive syndrome in patients with lumbar spinal stenosis in clinical decision limit stage 3: a retrospective study. BMC Musculoskelet Disord. 2023;24:851.
  • Schwartz CE, Stark RB, Balasuberamaniam P, et al. Moving toward better health: exercise practice is associated with improved outcomes after spine surgery in people with degenerative lumbar conditions. Can J Surg. 2021;64:E419-27.
  • Slater J, Kolber MJ, Schellhase KC, et al. The influence of exercise on perceived pain and disability in patients with lumbar spinal stenosis: a systematic review of randomized controlled trials. Am J Lifestyle Med. 2016;10:136-47.
  • Ju C-I, Kim P, Ha S-W, et al. Contraindications and complications of full endoscopic lumbar decompression for lumbar spinal stenosis: a systematic review. World Neurosurg. 2022;168:398-410.
  • Cheung PWH, Wong CKH, Lau ST, Cheung JPY. Cost analysis comparison between conventional microsurgical decompression and full-endoscopic interlaminar decompression for lumbar spinal stenosis surgery. J Spin Surg. 2020;6:721-8.
  • Kim HS, Raorane HD, Wu PH, et al. Incidental durotomy during endoscopic stenosis lumbar decompression: incidence, classification, and proposed management strategies. World Neurosurg. 2020;139:e13-22.

Exercise Tolerance Test as a Predictor of Functional Status and Surgical Outcomes in Symptomatic Spinal Stenosis Patients Undergoing Decompressive Lumbar Laminectomy

Year 2025, Volume: 7 Issue: 3, 584 - 90, 09.09.2025
https://doi.org/10.37990/medr.1647600

Abstract

Aim: The aim of our study is to demonstrate the effectiveness of total laminectomy, a less invasive technique compared to fusion procedures. Additionally, we aim to evaluate preoperative and postoperative functional mobility using the treadmill exercise test.
Material and Method: This clinical study includes 16 patients who underwent their first surgery for pure spinal stenosis at the Bakırköy Mental and Neurological Diseases Hospital, Neurosurgery Clinic III. All patients underwent an exercise tolerance test using a treadmill device preoperatively and at the third postoperative month. Prior to these tests, electrocardiography and chest radiography were performed.
Results: Preoperative exercise tolerance test results indicated that initial symptoms appeared at an average of 1.42 minutes, while severe symptoms preventing test continuation emerged at an average of 6.09 minutes. At the 3-month postoperative follow-up, the exercise tolerance test results demonstrated significant improvement. The average time to the onset of initial symptoms increased to 5.39 minutes, and the onset of severe symptoms was delayed to 11.08 minutes.
Conclusion: This study demonstrates that fusionless decompression techniques remain an effective treatment option. Additionally, preoperative and postoperative treadmill exercise tests can be utilized to assess disease status and severity. Moreover, these tests serve as an objective tool for evaluating the effectiveness of surgical treatment.

Ethical Statement

In our country, the first regulation on non-drug clinical research was published in the Official Gazette on March 11, 2010 (Issue No. 27518). Permission for this study was granted in 1997 by the Head of the Neurosurgery Department, Op. Dr. Halil Toplamaoğlu, at Bakırköy Mental and Neurological Diseases Hospital.

References

  • Friedmann E. Narrowing of the spinal canal due to thickened lamina a cause of low-back pain and sciatica. Clin Orthop Relat Res. 1961;21:190-7.
  • Kwon J-w, Moon S-H, Park S-Y, et al. Lumbar spinal stenosis: review update 2022. Asian Spine J. 2022;16:789-98.
  • Katz JN, Zimmerman ZE, Mass H, Makhni MC. Diagnosis and management of lumbar spinal stenosis: a review. JAMA. 2022;327:1688-99.
  • Lee BH, Moon S-H, Suk K-S, et al. Lumbar spinal stenosis: pathophysiology and treatment principle: a narrative review. Asian Spine J. 2020;14:682-93.
  • Kozanek M, Wang S, Passias PG, et al. Range of motion and orientation of the lumbar facet joints in vivo. Spine. 2009;34:E689-96.
  • Le CK, Rauschning, W Gleen W. Lateral lumbar spinal canal stenosis: classification, pathologic anatomy and surgical decompression. Spine (Phila Pa 1976). 1988;13:313-20.
  • Jensen RK, Harhangi BS, Huygen F, Koes B. Lumbar spinal stenosis. BMJ. 2021;373:n1581.
  • Genevay S, Courvoisier DS, Konstantinou K, et al. Clinical classification criteria for neurogenic claudication caused by lumbar spinal stenosis. The N-CLASS criteria. Spine J. 2018;18:941-7.
  • Weinstein JN, Tosteson TD, Lurie JD, et al. Surgical versus nonoperative treatment for lumbar spinal stenosis four-year results of the Spine Patient Outcomes Research Trial. Spine (Phila Pa 1976). 2010;35:1329-38.
  • Kjaer P, Leboeuf-Yde C, Korsholm L, et al. Magnetic resonance imaging and low back pain in adults: a diagnostic imaging study of 40-year-old men and women. Spine (Phila Pa 1976). 2005;30:1173-80.
  • Lee SY, Kim T-H, Oh JK, et al. Lumbar stenosis: a recent update by review of literature. Asian Spine J. 2015;9:818-28.
  • Kim HJ, Yang JH, Chang D-G, et al. Impact of preoperative total knee arthroplasty on radiological and clinical outcomes of spinal fusion for concurrent knee osteoarthritis and degenerative lumbar spinal diseases. J Clin Med. 2021;10:4475.
  • McNamara MJ, Barrett KG, Christie MJ, Spengler DM. Lumbar spinal stenosis and lower extremity arthroplasty. J Arthroplasty. 1993;8:273-7.
  • Park J, Ham D-W, Kwon B-T, et al. Minimally invasive spine surgery: techniques, technologies, and indications. Asian Spine J. 2020;14:694-701.
  • Park S-M, Park J, Jang HS, et al. Biportal endoscopic versus microscopic lumbar decompressive laminectomy in patients with spinal stenosis: a randomized controlled trial. Spine J. 2020;20:156-65.
  • Yaldiz C, Ozkal B, Guvenc Y, et al. Comparison of the rigid rod system with modular plate with the finite element analysis in short-segment posterior stabilization in the lower lumbar region. Turk Neurosurg. 2017;27:610-6..
  • Yilmaz A, Senturk S, Sasani M, et al. Disc rehydration after dynamic stabilization: a report of 59 cases. Asian Spine J. 2017;11:348-55.
  • Kwon J-W, Lee BH, Lee S-B, et al. Hand grip strength can predict clinical outcomes and risk of falls after decompression and instrumented posterolateral fusion for lumbar spinal stenosis. Spine J. 2020;20:1960-7.
  • Lee BH, Kim T-H, Park M-S, et al. Comparison of effects of nonoperative treatment and decompression surgery on risk of patients with lumbar spinal stenosis falling: evaluation with functional mobility tests. J Bone Joint Surg Am. 2014;96:e110.
  • Tokuhashi Y, Matsuzaki H, Sano S. Evaluation of clinical lumbar instability using the treadmill. Spine (Phila Pa 1976). 1993;18:2321-4.
  • Johnsson K-E, Uden A, Rosén I. The effect of decompression on the natural course of spinal stenosis: a comparison of surgically treated and untreated patients. Spine (Phila Pa 1976). 1991;16:615-9.
  • Turner JA, Ersek M, Herron L, Deyo R. Surgery for lumbar spinal stenosis: attempted meta-analysis of the literature. Spine (Phila Pa 1976). 1992;17:1-8.
  • Herno A, Airaksinen O, Saari T. Long-term results of surgical treatment of lumbar spinal stenosis. Spine (Phila Pa 1976). 1993;18:1471-4.
  • Deen HG, Zimmerman RS, Swanson SK, Larson TR. Assessment of bladder function after lumbar decompressive laminectomy for spinal stenosis: a prospective study. J Neurosurg. 1994;80:971-4.
  • Tram J, Srinivas S, Wali AR, et al. Decompression surgery versus interspinous devices for lumbar spinal stenosis: a systematic review of the literature. Asian Spine J. 2020;14:526-42.
  • Zhang J, Liu T-F, Shan H, et al. Decompression using minimally invasive surgery for lumbar spinal stenosis associated with degenerative spondylolisthesis: a review. Pain Ther. 2021;10:941-59.
  • Försth P, Ólafsson G, Carlsson T, et al. A randomized, controlled trial of fusion surgery for lumbar spinal stenosis. N Engl J Med. 2016;374:1413-23.
  • Hermansen E, Austevoll IM, Hellum C, et al. Comparison of 3 different minimally invasive surgical techniques for lumbar spinal stenosis: a randomized clinical trial. JAMA Netw Open. 2022;5:e224291.
  • Ulrich NH, Burgstaller JM, Valeri F, et al. Incidence of revision surgery after decompression with vs without fusion among patients with degenerative lumbar spinal stenosis. JAMA Netw Open. 2022;5:e2223803.
  • Deen HG, Zimmerman RS, Lyons MK, et al. Measurement of exercise tolerance on the treadmill in patients with symptomatic lumbar spinal stenosis: a useful indicator of functional status and surgical outcome. J Neurosurg. 1995;83:27-30.
  • Deen HG, Zimmerman RS, Lyons MK, et al. Use of the exercise treadmill to measure baseline functional status and surgical outcome in patients with severe lumbar spinal stenosis. Spine (Phila Pa 1976). 1998;23:244-8.
  • Deen HG, Zimmerman RS, Lyons MK, et al. Test-retest reproducibility of the exercise treadmill examination in lumbar spinal stenosis. Mayo Clin Proc. 2000;75:1002-7.
  • McIlroy S, Jadhakhan F, Bell D, Rushton A. Prediction of walking ability following posterior decompression for lumbar spinal stenosis. Eur Spine J. 2021;30:3307-18.
  • Higuchi D, Kondo Y, Miki T. Patterns of physical activity and exercise after lumbar surgery among Japanese patients with lumbar spinal stenosis. J Phys Ther Sci. 2021;33:146-52.
  • Nakae I, Hashida R, Otsubo R, et al. Impact of spinal surgery on locomotive syndrome in patients with lumbar spinal stenosis in clinical decision limit stage 3: a retrospective study. BMC Musculoskelet Disord. 2023;24:851.
  • Schwartz CE, Stark RB, Balasuberamaniam P, et al. Moving toward better health: exercise practice is associated with improved outcomes after spine surgery in people with degenerative lumbar conditions. Can J Surg. 2021;64:E419-27.
  • Slater J, Kolber MJ, Schellhase KC, et al. The influence of exercise on perceived pain and disability in patients with lumbar spinal stenosis: a systematic review of randomized controlled trials. Am J Lifestyle Med. 2016;10:136-47.
  • Ju C-I, Kim P, Ha S-W, et al. Contraindications and complications of full endoscopic lumbar decompression for lumbar spinal stenosis: a systematic review. World Neurosurg. 2022;168:398-410.
  • Cheung PWH, Wong CKH, Lau ST, Cheung JPY. Cost analysis comparison between conventional microsurgical decompression and full-endoscopic interlaminar decompression for lumbar spinal stenosis surgery. J Spin Surg. 2020;6:721-8.
  • Kim HS, Raorane HD, Wu PH, et al. Incidental durotomy during endoscopic stenosis lumbar decompression: incidence, classification, and proposed management strategies. World Neurosurg. 2020;139:e13-22.
There are 40 citations in total.

Details

Primary Language English
Subjects Brain and Nerve Surgery (Neurosurgery)
Journal Section Original Articles
Authors

Özden Erhan Sofuoğlu This is me 0000-0001-7560-7331

Abdullah Emre Taçyıldız 0000-0001-5806-243X

Publication Date September 9, 2025
Submission Date March 3, 2025
Acceptance Date March 22, 2025
Published in Issue Year 2025 Volume: 7 Issue: 3

Cite

AMA Sofuoğlu ÖE, Taçyıldız AE. Exercise Tolerance Test as a Predictor of Functional Status and Surgical Outcomes in Symptomatic Spinal Stenosis Patients Undergoing Decompressive Lumbar Laminectomy. Med Records. September 2025;7(3):584-90. doi:10.37990/medr.1647600

17741

Chief Editors

MD, Professor. Zülal Öner
İzmir Bakırçay University, Department of Anatomy, İzmir, Türkiye

Assoc. Prof. Deniz Şenol
Düzce University, Department of Anatomy, Düzce, Türkiye

Editors
Assoc. Prof. Serkan Öner
İzmir Bakırçay University, Department of Radiology, İzmir, Türkiye
 
E-mail: medrecsjournal@gmail.com

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Medical Records Association (Tıbbi Kayıtlar Derneği)
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Web: www.tibbikayitlar.org.tr