Factors Associated With Persistence of Pain in Lumbar Stenosis Surgery

Abstract

Objective: The objective of this study was to determine the factors associated with the persistence of pain in patients operated on for lumbar stenosis. Method: One hundred and fifty-three patients were studied, divided into two groups: 1) Patients with persistent pain in varying degrees, 2) Patients without pain. Age, sex, affected levels, comorbidities, surgical risk, and type of surgical procedure were evaluated. Results: There were 108 patients in the group with pain and 45 in the group without pain. In the group with pain, there were 28 patients with diabetes mellitus, 31 smokers, and 28 alcohol-dependent patients, with a significant difference of p = 0.001 and an RR = 1.1. A simple widening procedure was performed in 48 patients in the group with pain and 12 patients in the group without pain, with RR = 0.8, and widening plus instrumentation was performed in 7 patients in both the with and without pain groups. Conclusion: The indication of a surgical procedure in patients with spinal stenosis must take many factors into account in addition to clinical factors and the segments affected, since these factors impact patient prognosis. In the multivariate analysis, the variable most closely associated with persistent pain was the procedure performed. Level of Evidence III; Case-control study.g

Surgical Results of Lumbar Canal Recalibration by Modified Senegas Technique

“…Conservative treatment is based on the use of non-steroidal antiinflammatory drugs, physical therapy, which requires constancy and at least three months of continuity, and lifestyle changes, not always accepted by patients, and approximately 60% of cases do not resolve with that treatment. [3] The most practiced surgical treatment until 5 or 6 years ago was decompression and posterior arthrodesis of the lumbar segment with or without instrumentation. Still, as it is not performed, immobilization in a cast brace is necessary for six months.…”