An Assessment of Surgery for Spinal Stenosis: Time Trends, Geographic Variations, Complications, and Reoperations

Ciol, Márcia A.; Deyo, Richard A.; Howell, Eric; Kreif, Suzanne

doi:10.1111/j.1532-5415.1996.tb00915.x

Cited by 420 publications

(272 citation statements)

References 14 publications

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“…Another study also showed increased postoperative mortality with age, and high comorbidity [7]. The gender differences in our study could be due to confounding factors.…”

Section: Discussionsupporting

confidence: 43%

“…At an assessment of spinal stenosis surgery in Medicare beneficiaries in the US, the rate of surgery was observed to have increased eightfold from 1979 to 1992 [7], and the same study reported rates of surgery varying between US states by almost a factor of five.…”

Section: Discussionmentioning

confidence: 98%

“…The incidence of surgical management has been reported from individual regions or hospitals [4,7,11,16]. The characteristics and mortality of these patients have only been reported occasionally [8,17].…”

mentioning

confidence: 99%

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Spinal stenosis surgery in Sweden 1987?1999

Kå

Blomqvist

Granath

et al. 2003

European Spine Journal

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“…Another study also showed increased postoperative mortality with age, and high comorbidity [7]. The gender differences in our study could be due to confounding factors.…”

Section: Discussionsupporting

confidence: 43%

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Spinal stenosis surgery in Sweden 1987?1999

Kå

Blomqvist

Granath

et al. 2003

European Spine Journal

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“…Regarding lumbar fusion procedures, several studies report on notable regional differences in the number of patients operated, depending on surgeons' beliefs or on other subjective factors, such as organization and financing of health services [18,47], rather than on clinical or demographic criteria. Several studies emphasize the importance of an adequate selection of patients to undergo surgical lumbar interventions [11,12,14,39]. Thus far, there has been no agreement among different authors on guidelines to specify the situations in which arthrodesis is justified in terms of results, risks and complications.…”

Section: Discussionmentioning

confidence: 99%

Predictors of outcome after decompressive lumbar surgery and instrumented posterolateral fusion

Soriano

Revuelta²,

Fabregate

et al. 2010

Eur Spine J

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There has been no agreement among different authors on guidelines to specify the situations in which arthrodesis is justified in terms of results, risks and complications. The aim of this study was to identify preoperative predictors of outcome after decompressive lumbar surgery and instrumented posterolateral fusion. A prospective observational study design was performed on 203 consecutive patients. Potential preoperative predictors of outcome included sociodemographic factors as well as variables pertaining to the preoperative clinical situation, diagnosis, expectations and surgery. Separate multiple linear regression models were used to assess the association between selected predictors and outcome variables, defined as the improvement after 1 year on the visual analog scale (VAS) for back pain, VAS for leg pain, physical component scores (PCS) of SF-36 and Oswestry disability index (ODI). Follow-up was available for 184 patients (90.6%). Patients with higher educational level and optimistic preoperative expectations had a more favourable postoperative leg pain (VAS) and ODI. Smokers had less leg pain relief. Patients with better mental component score (emotional health) had greater ODI improvement. Less preoperative walking capacity predicted more leg pain relief. Patients with disc herniation had greater relief from back pain and more PCS and ODI improvement. More severe lumbar pain was predictive of less improvement on ODI and PCS. Age, sex, body mass index, analgesic use, surgeon, self-rated health, the number of decompressed levels and the length of fusion had no association with outcome. This study concludes that a higher educational level, optimistic expectations for improvement, the diagnosis of ''disc herniation'', less walking capacity and good emotional health may significantly improve clinical outcome. Smoking and more severe lumbar pain are predictors of worse results.

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“…With the absolute and relative growth of the aged part of the population in the industrialized countries the prevalence of chronic back pain is also growing and the number of elderly patients requiring spine surgery continues to increase [4,8,11]. One of the most frequent degenerative conditions in the aged spine is lumbar spinal stenosis (LSS), which generally becomes symptomatic after the age of 50 [17].…”

Section: Introductionmentioning

confidence: 99%

Predictors of surgical, general and follow-up complications in lumbar spinal stenosis relative to patient age as emerged from the Spine Tango Registry

et al. 2011

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Introduction Published opinions regarding the outcomes and complications in older patients have a broad spectrum and there is a disagreement whether surgery in older patients entails a higher risk. Therefore this study examines the risk of surgery for lumbar spinal stenosis relative to age in the pooled data set of the Spine Tango registry. Materials and methods Between May 2005 and February 2010 the database query resulted in 1,764 patients. The patients were subdivided into three socio-economically relevant age groups: \65 years, 65-74 years, C75 years. Frequencies for occurred surgical, general and follow-up complications were assessed. Multivariate and univariate logistic regressions were performed to reveal predictors for respective complication types. Results and discussion Our study found that age, ASA status and blood loss were significant co-varieties for the occurrence of general complications. The risk of general complications is increased in older versus younger patients. Fusion or rigid stabilization does not lead to more complications. Surgical complications as well as complication rates at follow-up showed no significant age-related variation. Physician-based outcome was good or excellent in over 80% of patients in all age groups.

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An Assessment of Surgery for Spinal Stenosis: Time Trends, Geographic Variations, Complications, and Reoperations

Cited by 420 publications

References 14 publications

Spinal stenosis surgery in Sweden 1987?1999

Spinal stenosis surgery in Sweden 1987?1999

Predictors of outcome after decompressive lumbar surgery and instrumented posterolateral fusion

Predictors of surgical, general and follow-up complications in lumbar spinal stenosis relative to patient age as emerged from the Spine Tango Registry

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