Outcomes and Patient Satisfaction Following Micro-endoscopic Laminotomy for Lumbar Spinal Stenosis: A Comprehensive Analysis of Multiple Lumbar Spine Scoring Systems

AIM: The aim of this study is to examine how patient-reported satisfaction at one year after micro-endoscopic laminotomy (MEL) for lumbar spinal stenosis (LSS) aligns with conventional outcome measures and to assess whether these instruments adequately reflect patient perspectives. MATERIALS AND METHODS: We conducted a single-center retrospective cohort study of adults undergoing MEL for symptomatic LSS. Patients completed preoperative and one-year postoperative assessments, including visual analogue scales for pain and numbness, the Roland-Morris Disability Questionnaire (RMDQ), the Oswestry Disability Index (ODI), selected Japanese Orthopaedic Association (JOA) items, and the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ). Patient satisfaction was captured by a recommendation-level item at one year. Pre-post changes and associations with satisfaction were analyzed using standard parametric or nonparametric tests as appropriate. RESULTS: One-year satisfaction was positively associated with postoperative functioning in social and psychological domains and with walking ability and pain-related impairment, and it was inversely associated with residual lower back pain and disability. Numbness showed a weaker association with satisfaction. Although conventional scales documented clinical improvement, they accounted for only part of the variance in satisfaction. CONCLUSION: Conventional outcome scores capture important but incomplete aspects of recovery after MEL. Incorporating a brief, patient-reported satisfaction measure alongside established instruments can provide a more balanced appraisal of outcomes and support shared decision-making. Prospective studies are warranted to refine how satisfaction is integrated into routine evaluation.