Health-related quality of life (EQ-5D) before and one year after surgery for lumbar spinal stenosis

Abstract

We investigated the pre-operative and one-year post-operative health-related quality of life (HRQoL) outcome by using a Euroqol (EQ-5D) questionnaire in 230 patients who underwent surgery for lumbar spinal stenosis. Data were obtained from the National Swedish Registry for operations on the lumbar spine between 2001 and 2002. We analysed the pre- and postoperative quality of life data, age, gender, smoking habits, pain and walking ability. The relative differences were compared to a Swedish EQ-5D population survey. The mean age of the patients was 66 years, and there were 123 females (53%). Before the operation 62 (27%) of the patients could walk more than 500 m. One year after the operation 150 (65%) were able to walk 500 m or more. The mean EQ-5D score improved from 0.36 to 0.64, and the HRQoL improved in 184 (80%) of the patients. However, they did not reach the level reported by a matched population sample (mean difference 0.18). Women had lower pre- and post-operative EQ-5D scores than men. Severe low back pain was a predictor for a poor outcome.

Evaluation of clinical results and quality of life after surgical reconstruction for rheumatoid cervical spine

“…The EQ-5D has also been used to evaluate patients who have undergone spine surgery. Jansson et al studied health-related QOL in patients before and after surgery for herniated lumbar disc and lumbar spinal stenosis; they report that the post-surgery EQ-5D utility weight improved from 0.29 (preoperatively) to 0.70 in herniated lumbar disc and from 0.36 to 0.64 in lumbar spinal stenosis [24,25]. However, to our knowledge, no study has evaluated health-related QOL using the EQ-5D before and after surgical reconstruction for cervical disorders in RA.…”

Determinants of outcome in lumbar spinal stenosis surgery

“…Many advocate a concomitant fusion for LSS with DS based on data in the literature (Herkowitz and Kurz 1991;Bridwell et al 1993;Mardjetko et al 1994;Ghogawala et al 2004;Martin et al 2007). The arguments against fusion are that adding fusion has not beenIntroduction surgery for LSS has consistently shown patients, in spite of surgical treatment, to have residual leg and back symptoms and lower HRQoL compared to the background population (Cornefjord et al 2000;Jansson et al 2009;Hara et al 2010). Furthermore, the satisfaction rate after surgery is no more than 60-70% and in patients with predominant back pain, the satisfaction rate seems even lower (Katz et al 1995b;Strömqvist et al 2013a).…”

“…Patients with LSS are often elderly and often afflicted with comorbidities that add to disability, reduced function and reduced HRQoL. Patients with LSS often have very low preoperative HRQoL compared to an age matched population (Zanoli et al 2006a;Jansson et al 2009). Although significant clinical improvements are associated with surgery for LSS with and without DS on a group level it remains difficult to predict prognosis in terms of function, pain, and HRQoL on an individual basis.…”

From the From the Patient’s Point of View: Patient Centered Outcomes in Spine Surgery

“…Current validated measures for patient outcomes in spine surgery include the VAS [13], ODI [14][15][16], SF-36 [17], and EQ-5D [18][19][20] ( Table 4). The VAS is a self-reported, one-dimensional pain rating scale.…”

“…A more general measure of quality of life, the SF-36, is a multipurpose, short-form health survey with 36 items that yields an eight-scale profile of scores as well as overall physical and mental health summary measures [17]. Similarly, the EQ-5D is a two-part self-reported multi-dimensional questionnaire that generates 243 possible health states based on three possible answers for five dimensions [19]. The EQ-5D also measures general quality of life and yields a single utility score of 0-1: 0 representing death and one representing full health.…”