Five-Year Outcomes of Surgical Treatment for Degenerative Lumbar Spinal Stenosis

Yamashita, Kazuo; Ohzono, Kenji; Hiroshima, Kazuo

doi:10.1097/01.brs.0000219940.26390.26

Cited by 60 publications

(21 citation statements)

References 32 publications

(25 reference statements)

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“…5,8,12,14,2021,22 Yasar et al report the results of a prospective study of 125 patients with spinal stenosis with 2 year followup. The authors found no correlation between DOS and outcome of treatment, although the incidence of DS is not specified in the population.…”

Section: Discussionmentioning

confidence: 99%

Does the Duration of Symptoms in Patients With Spinal Stenosis and Degenerative Spondylolisthesis Affect Outcomes?

Radcliff¹,

Rihn²,

Hilibrand³

et al. 2011

Spine

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Study Design Retrospective subgroup analysis of prospectively collected data according to treatment received. Objective The purpose of this study is to determine if the duration of symptoms affects outcomes following the treatment of spinal stenosis (SS) or degenerative spondylolisthesis (DS). Summary of Background Data The Spine Outcomes Research Trial (SPORT) study was designed to provide scientific evidence on the effectiveness of spinal surgery versus a variety of non-operative treatments. Methods An as-treated analysis was performed on patients enrolled in the Spine Patient Outcomes Research Trial (SPORT) for the treatment of SS or DS. A comparison was made between patients with SS with ≤12 months (n=405) and those with >12 months (n=227) duration of symptoms. A comparison was also made between patients with DS with ≤12 months (n=397) and those with >12 months (n=204) duration of symptoms. Baseline patient characteristics were documented. Primary and secondary outcomes were measured at baseline and at regular follow-up time intervals up to 4 years. The difference in improvement among patients whose surgical or nonsurgical treatment began less than or greater than 12 months after the onset of symptoms was measured. In addition, the difference in improvement with surgical versus nonsurgical treatment (treatment effect) was determined at each follow-period for each group. Results At final followup, there was significantly less improvement in primary outcome measures in SS patients with >12 months symptom duration. Primary and secondary outcome measures within the DS group did not differ according to symptom duration. There were no statistically significant differences in treatment effect of surgery in SS or DS patients. Conclusions Patients with spinal stenosis with fewer than twelve months of symptoms experienced significantly better outcomes with surgical and nonsurgical treatment relative to those with symptom duration greater than twelve months. There was no difference in outcome of patients with degenerative spondylolisthesis according to symptom duration.

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Section: Discussionmentioning

confidence: 99%

Does the Duration of Symptoms in Patients With Spinal Stenosis and Degenerative Spondylolisthesis Affect Outcomes?

Radcliff¹,

Rihn²,

Hilibrand³

et al. 2011

Spine

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“…Most previous studies report that increasing age is associated with less improvement after spinal stenosis surgery [1, 13]. …”

Section: Discussionmentioning

confidence: 99%

“…In what extent the patients regards themselves as satisfied with the change due to surgery is probably connected to various factors as the actual level of symptoms, their physical and social ability. K. Yamashita et al, [13] underline that the patients’ satisfaction level seem to be closer associated with the end results; the actual symptom level, than with the change in scores.…”

Section: Discussionmentioning

confidence: 99%

“…Previous findings regarding the influence of age upon the effect of surgical treatment are controversial. Some studies have found that increasing age is associated with less favourable outcomes [1, 13], whereas others have found the opposite result [14]. Female gender has also shown to be connected with less satisfaction in several studies [15, 16].…”

Section: Introductionmentioning

confidence: 99%

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Prognosis of Surgical Treatment for Degenerative Lumbar Spinal Stenosis: A Prospective Cohort Study of Clinical Outcomes and Health-Related Quality of Life Across Gender and Age Groups

Thornes¹,

Ikonomou²,

Grotle³

2011

TOORTHJ

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Degenerative lumbar spinal stenosis is a common condition and the most usual indication for spinal surgery in adult patients. The main objective of this study was to investigate clinical outcomes, health-related quality of life (HRQoL) and satisfaction among patients with a diagnosed lumbar spinal stenosis who were surgically treated, and whether these outcomes differed according to gender and age. Surgery was performed on 100 patients with clinical and radiological defined lumbar spinal stenosis. All patients completed questionnaires twice before surgery and at 6 weeks, 12 weeks, and 1 year postoperatively. Main outcomes were symptoms, physical function and patient satisfaction assessed by the Swiss Spinal Stenosis Questionnaire and HRQoL by the Short Form 36 health survey (SF36). There were large improvements in all clinical outcomes and in the physical subscales of the SF36. A marked reduction of average 32.3% was seen in symptoms already at 6 weeks follow-up. Physical function had improved with an average of 29.8% at 1-year follow-up. There was no statistical significant effect of age and gender on symptoms and physical function. Patients more than 65 years were significantly less satisfied at the 1-year follow-up as compared to the younger patients (p=0.012). This study showed that the majority of patients improved significantly in symptoms, physical function and physical HRQoL after surgery for degenerative lumbar spinal stenosis, regardless of age and gender. Age showed to be closely connected to satisfaction.

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“…They found that the results of the surgery improved steadily for 6 months after the operation, and then remained stable for the next 5 years. In elderly patients, especially women, results were worse than those in young men and women [20]. Our results showed a decrease in pain level after surgery, from VAS 8.57 in the PLIF group and 8.17 in the decompression group, to 4 and 4.17 after 1 year, and slight increase to 4.96 and 4.35, respectively, after 10 years.…”

Section: Discussionmentioning

confidence: 49%

Evaluation of Functional Outcomes in Individuals 10 Years after Posterior Lumbar Interbody Fusion with Corundum Implants and Decompression: A Comparison of 2 Surgical Techniques

Cabak

2014

Med Sci Monit

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BackgroundThe purpose of this study was to evaluate lumbar spine-related functional disability in individuals 10 years after lumbar decompression and lumbar decompression with posterior lumbar interbody fusion (PLIF) with corundum implants surgery for degenerative stenosis and to compare the long-term outcome of these 2 surgical techniques.Material/MethodsFrom 1998 to 2002, 100 patients with single-level lumbar stenosis were surgically treated. The patients were randomly divided into 2 groups that did not differ in terms of clinical or neurological symptoms. Group A consisted of 50 patients who were treated with PLIF and the use of porous ceramic corundum implants; the mean age was 57.74 and BMI was 27.34. Group B consisted of 50 patients treated with decompression by fenestration; mean age was 51.28 and the mean BMI was 28.84.ResultsThere was no statistical significance regarding age, BMI, and sex. Both treatments revealed significant improvements. In group A, ODI decreased from 41.01% to 14.3% at 1 year and 16.3 at 10 years. In group B, ODI decreased from 63.8% to 18.36% at 1 year and 22.36% at 10 years. The difference between groups was statistically significant. There were no differences between the groups regarding the Rolland-Morris disability questionnaire and VAS at 1 and 10 years after surgery.ConclusionsLong-term results evaluated according to the ODI, the Rolland-Morris disability questionnaire, and the VAS showed that the both methods significantly reduce patient disability, and this was maintained during next 10 years. The less invasive fenestration procedure was only slightly less favorable than surgical treatment of stenosis by both PLIF with corundum implants and decompression.

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Five-Year Outcomes of Surgical Treatment for Degenerative Lumbar Spinal Stenosis

Abstract: In patients undergoing surgery for degenerative lumbar spinal stenosis, older age predicts a greater risk of late recurrence of symptoms, and women have higher VAS scores than men after surgery.

Cited by 60 publications

References 32 publications

Does the Duration of Symptoms in Patients With Spinal Stenosis and Degenerative Spondylolisthesis Affect Outcomes?

Does the Duration of Symptoms in Patients With Spinal Stenosis and Degenerative Spondylolisthesis Affect Outcomes?

Prognosis of Surgical Treatment for Degenerative Lumbar Spinal Stenosis: A Prospective Cohort Study of Clinical Outcomes and Health-Related Quality of Life Across Gender and Age Groups

Evaluation of Functional Outcomes in Individuals 10 Years after Posterior Lumbar Interbody Fusion with Corundum Implants and Decompression: A Comparison of 2 Surgical Techniques

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