|Comparison of vascular with neurogenic claudication|
|Relief of pain||Standing||Sitting - flexed|
|Walk uphill||Pain||No pain|
|Bicycle ride||Pain||No pain|
|Type of pain||Cramp||Numbness, ache|
|Skin||Loss of hair||Normal|
|Limitation of spine||Uncommon||Common|
Because the primary complaint often is back pain and some leg pain, pain relief after surgery may not be complete. Most series report a 64% to 91% rate of improvement, with 42% in patients with diabetes, but most patients still have some minor complaints, usually referable to the preexisting degenerative arthritis of the spine. Neurological findings, if present, improve inconsistently after surgery. In a series reported by Guigui et al., only 30% had complete improvement in motor symptoms after laminectomy, with 58% regaining grade 4 strength or better at a mean follow-up of 3 years. Reoperation rates vary from 6% to 23%. Prognostic factors include better results with a disc herniation, stenosis at a single level, weakness of less than 6 weeks' duration, monoradiculopathy, and age younger than 65 years. Reversal of neurological consequences of spinal stenosis seems to be a relative indication for surgery unless the symptoms are acute.