Functional Outcome Study of Patients After Surgical Decompression for Lumbar Spinal Stenosis: Effects of Concomitant Pathology

Abstract

The aim of this study is to identify factors associated with poor outcome in the medium (2-5 years) postoperative period following lumbar stenosis surgery. Fifty-six consecutive patients who underwent decompression for lumbar spinal stenosis were retrospectively analyzed using chart and radiologic review, questionnaire using American Association of Orthopaedic Surgeon's MODEM questionnaire containing disability, symptoms, and illness rating, as well as Short Form-36 questionnaires. Postoperatively, there was 98% partial or total relief in leg pain, 85% had partial or total relief in back pain, and 69% had partial or total recovery of neurologic deficit. Functional outcome according to the Short Form-36 was comparable with the age-adjusted population when other comorbidities were taken into account. We found a direct relationship between poor outcome and coexisting medical conditions (p <0.001). Accompanying comorbid conditions have a significant impact on outcome after surgical decompression for lumbar spinal stenosis.

Patient Outcome Following Rehabilitation for Rotator Cuff Repair Surgery: The Impact of Selected Medical Comorbidities

“…In part, it is difficult to compare the results from the Tashjian et al 21 study and our study with the above-mentioned studies because of the differences 12,19 in how comorbidity was assessed. For example, Katz et al 12 utilized the Cumulative Illness Rating Scale, which rates the severity of comorbid illness in the 13 organ systems on a scale of 0 to 4 points, Tashjian et al 21 and Modifi et al 19 used the MODEMS (Musculoskeletal Outcomes Data Evaluation and Management System), and we used a total number of comorbidities from a list of 9 most frequently noted illnesses in our population. Maybe the impact on functional outcome and levels of disability is contingent on the presence of certain comorbidities and not of others.…”

“…Cardiovascular and chronic pulmonary diseases, osteoarthrosis, and rheumatoid arthritis were the most frequently noted comorbid conditions. Mofidi et al 19 also noted an association of poor outcome and coexisting medical conditions after surgical decompression for lumbar spinal stenosis. In fact, the presence of comorbid conditions had the strongest correlation with poor symptomatic and functional outcomes.…”

“…This surprising finding-the lack of impact of comorbidities on post-rotator cuff repair outcomes-runs contrary to postoperative findings for other patient populations. 12,19 Katz et al 12 reported that the presence of patient comorbidities was associated with poor long-term patient outcomes and functional limitations following decompressive laminectomy for degenerative lumbar stenosis. Cardiovascular and chronic pulmonary diseases, osteoarthrosis, and rheumatoid arthritis were the most frequently noted comorbid conditions.…”

“…In fact, the presence of comorbid conditions had the strongest correlation with poor symptomatic and functional outcomes. 19 The purposes of this study were to (1) assess functional outcome and perception of general health status in patients following physical therapy management post-rotator cuff repair surgery, and (2) determine the impact of patients' existing health histories on improvement in shoulder function and general health status. Identifying clinical factors that impact recovery following rotator cuff repair may assist clinicians in establishing a more accurate patient prognosis.…”

The Surgical Management of Low Grade Single Level Adult Degenerative Spondylolisthesis: Posterolateral Fusion versus Posterior Lumbar Interbody Fusion

“…Clinical assessment involved the measurement of the 10-point visual analog back pain score (VAS), Oswestry Disability Index (ODI) for back pain, and SF 12 Health Survey. All comorbidities were matched between the patients to reduce error in outcome measurement [8].…”