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Giakas et al. Art Int Surg 2024;4:233-46 https://dx.doi.org/10.20517/ais.2024.24 Page 241

symptoms. Another major deficiency in this response is the lack of data regarding outcomes after surgery,
which contributed to a reduction in the overall score of the response.

8. What is the success rate of lumbar decompression surgery?
The success rate of lumbar decompression surgery can vary based on several factors, including the specific
condition being treated, the underlying cause of symptoms, the surgical technique used, the patient’s overall
health, and the criteria used to define success. Here is a general overview:

(1) Herniated disc: Microdiscectomy or other decompression surgeries for herniated discs have generally
high success rates, often above 80%-90%.
(2) Spinal stenosis: Success rates vary, but many studies report favorable outcomes in terms of symptom
relief.
(3) Foraminal stenosis: Surgery for foraminal stenosis, which involves widening the nerve exit openings, can
lead to relief of leg pain and other symptoms. Success rates vary but can be quite favorable.
(4) Degenerative disc disease: Success rates are often good, but outcomes can vary based on factors like the
extent of degeneration and overall health.
(5) Spondylolisthesis: Success rates depend on factors like the grade of slippage and the success of fusion.
Overall, many patients experience symptom improvement.
(6) Recurrent symptoms: While many patients experience relief after lumbar decompression surgery, there
is a small risk of recurrent symptoms due to factors such as scar tissue formation, incomplete
decompression, or new issues.

Attending 1 Score: 2
Attending 2 Score: 2

Analysis: This response was generally of poor quality and of little use to patients. The reviewers both felt
that the response did not delineate the differing success rates of PLD for any of the indications listed after
“herniated disk”. Secondarily, the response repeats the same general answer for almost every indication -
some of which, including spondylolisthesis, are typically treated by spinal fusion and not a standalone PLD.
This could be seen as a point of frustration on the side of the patient as they begin to ask deeper questions
from ChatGPT but are met with a plateauing effect of new information without specific resources to address
lingering questions.

9. What are the different approaches for lumbar decompression surgery?
There are several surgical approaches for lumbar decompression, each designed to address specific
conditions and anatomical considerations. The choice of approach depends on factors such as the
underlying condition, the level of the spine affected, the surgeon’s expertise, and patient characteristics.
Here are some common approaches for lumbar decompression surgery:

(1) Traditional open approach:
- Involves a larger incision and more tissue dissection.
- Provides direct visualization of the surgical area.
- Allows for comprehensive decompression and treatment of complex conditions.
- Examples include laminectomy, laminotomy, and discectomy.

(2) Minimally invasive approach:
- Utilizes smaller incisions and specialized instruments.