What question did this study set out to answer?

The central aim is to compare the outcomes and minimal clinically important differences between single-level and two-level laminectomy for treating lumbar spinal stenosis.

February 28, 2026Medicinski Glasnik0 citationsOpen Access

Minimal clinically important difference (MCID)-based analysis of single- versus two-level laminectomy for lumbar spinal stenosis: a prospective study

EBEmir BegagićUniversity of Zenica HBHakija Bečulić FAFahrudin AlićUniversity of Zenica

Key Points

The central aim is to compare the outcomes and minimal clinically important differences between single-level and two-level laminectomy for treating lumbar spinal stenosis.
Prospective design including 119 patients with lumbar spinal stenosis.
Patients underwent either single-level or two-level laminectomy.
Preoperative assessments and 1- and 6-month postoperative evaluations were conducted using ODI, SSSQ, and VAS for pain.
Single-level laminectomy patients had lower ODI and VAS scores compared to two-level patients at 6 months.
Motor deficits and urinary dysfunction were less frequent in the single-level group at 1 month.
More single-level patients achieved MCID for ODI and SSSQ compared to two-level patients at 6 months.

Abstract

pstrongAim /strongTo compare outcomes and minimal clinically important differences (MCID) between single-level laminectomy (SLL) and two-level laminectomy (TLL) for lumbar spinal stenosis (LSS)./p pstrongMethods /strongThis prospective study included 119 patients with confirmed LSS who underwent SLL or TLL at Cantonal Hospital Zenica from January 2018 to January 2025. Assessments were performed preoperatively and at 1 and 6 months postoperatively using the Oswestry Disability Index (ODI), Swiss Spinal Stenosis Questionnaire (SSSQ), and Visual Analogue Scale (VAS) for back and leg pain, along with evaluation of motor, sensory, and urinary function. MCID values were used to assess meaningful improvement./p pstrongResults /strongAt six months, SLL patients had lower ODI (15.0 vs. 18.0, p = 0.006), VAS-LB (3.0 vs. 5.0, p lt; 0.001), and SSSQ scores (17.2 vs. 21.6, p lt; 0.001) than TLL patients. Motor deficits (14.8% vs. 35.5%, p = 0.019) and urinary dysfunction at 1 month (5.7% vs. 22.6%, p = 0.013) were less frequent in SLL. More SLL patients achieved MCID for ODI (80.7% vs. 58.1%, p = 0.024) and SSSQ (73.9% vs. 48.4%, p = 0.017) at 6 months, with TLL patients 28% and 34% less likely to reach MCID for ODI and SSSQ, respectively. No significant differences were found preoperatively or at 1 month./p pstrongConclusion /strongThe study suggests that SLL and TLL have comparable outcomes, with a slight tendency toward better functional improvement and fewer deficits after SLL./p

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