Impact of occupational characteristics on return to work for employed patients after elective lumbar spine surgery

Khan, Inamullah; Bydon, Mohamad; Archer, Kristin R.; Sivaganesan, Ahilan; Asher, Anthony M.; Alvi, Mohammed Ali; Kerezoudis, Panagiotis; Knightly, John J; Foley, Kevin T.; Bisson, Erica F.; Shaffrey, Christopher I.; Asher, Anthony L.; Spengler, Dan M.; Devin, Clinton J.

doi:10.1016/j.spinee.2019.08.007

Cited by 38 publications

(34 citation statements)

References 24 publications

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“…The inability to carry out basic daily activities due to lower back pain is expressed by the Oswestry disability index calculated using a questionnaire based on the intensity of pain, carrying out basic daily activities, lifting bigger loads, walking, sitting, standing, sleeping, social life, sex life and traveling (11).…”

Section: Discussionmentioning

confidence: 99%

Endoscopic discectomy as an effective treatment of a herniated intervertebral disc

Mláka¹,

Rapčan²,

Burianek³

et al. 2020

BLL

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OBJECTIVE: Prospective observational multicentre two-arm parallel study describing clinical outcome after endoscopic discectomy provided via transforaminal and interlaminar approach. BACKGROUND: Endoscopic lumbar discectomy (ELD) is a percutaneous minimally invasive procedure for the treatment of herniated lumbar discs. Herniations at lumbar intervertebral disc levels of L1/2, L2/3, L3/4 and L4/5 are mostly accessed by the transforaminal (TF) approach. However, due to the anatomic position of the iliac crest, the L5/S1 level might not be reachable by the transforaminal approach, while the interlaminar (IL) percutaneous approach should be a suitable alternative. METHODS: In a prospective observational multicentre clinical trial NCT0274311, we compared the clinical outcomes of two groups of patients who underwent ELD via IL (83) and TF (103) approach. The subjects were followed for 12 months via planned examinations by pain physicians. The levels of leg pain and back pain intensity were assessed by an 11-point numerical ratings scale (NRS). Patient's functional disability was assessed by the Oswestry Disability Index (ODI). RESULTS: Study subjects showed a signifi cant decrease in ODI scores in both groups (p < 0.001) The values of mean preoperative ODI in TF and IL groups were 39.1 ± 15.7 and 43.4 ± 16, respectively. Postoperative values in the latter groups were 14.8 ± 14.9 and 17.5 ± 14.3, respectively. Signifi cantly lower pain scores for leg pain (p<0.001) and back pain (p < 0.001) were also recorded at 12-month follow-ups. CONCLUSION: Because both procedures are strictly percutaneous; they are now more commonly performed by interventional pain physicians as a safe and effective alternative to open surgical spine procedures (Tab.

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Section: Discussionmentioning

confidence: 99%

Endoscopic discectomy as an effective treatment of a herniated intervertebral disc

Mláka¹,

Rapčan²,

Burianek³

et al. 2020

BLL

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“…Surgical procedures are commonly used in the treatment of lumbar spinal stenosis, including total laminectomy decompression and lumbar intervertebral fusion with pedicle screw fixation 3 . Although these approaches can effectively achieve spinal canal decompression, the operation causes great damage to the posterior column of the spine, which can lead to lumbar instability, degenerative deformity, adjacent segment disease, and other complications 4, 5 . Therefore, it is imperative to adopt appropriate surgical methods for elderly patients with degenerative lumbar spinal stenosis.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Endoscopic Unilateral Laminotomy and Bilateral Decompression for Lumbar Spinal Stenosis

Zhao

Geng

et al. 2021

Orthopaedic Surgery

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To introduce a new surgery, percutaneous endoscopic unilateral laminotomy and bilateral decompression (Endo‐ULBD) using visual trepan, and investigate its efficacy and safety in elderly patients with lumbar spinal stenosis. In our retrospective study, a total of 69 patients were enrolled between March 2018 and September 2018; 31 patients were treated with Endo‐ULBD and 38 patients were treated with posterior lumbar interbody fusion surgery (PLIF). The operation time, intraoperative blood loss, and hospitalization duration were compared between the two groups. A visual analog scale (VAS) was used to evaluate the degree of pain. The Oswestry Disability Index (ODI) and European Quality of Life‐5 Dimensions (EQ‐5D) were used to evaluate lumbar function and quality of life, respectively. Lumbar X‐ray, computed tomography (CT) and magnetic resonance imaging (MRI) were performed postoperatively at different time points. MacNab's outcome assessment and perioperative complications were also documented. The surgeon completed all surgeries successfully, and all 69 patients were followed up. The operative time of the Endo‐ULBD group was 60.68 ± 0.47 min, while that of the PLIF group was 120.23 ± 10.24 min. The operative time of the Endo‐ULBD group was shorter than that of the PLIF group, and the difference was statistically significant (P < 0.001). The volume of intraoperative blood loss was 47.25 ± 0.43 mL in the Endo‐ULBD group and 256.90 ± 20.83 mL in the PILF group (P < 0.001). The length of hospital stay in the Endo‐ULBD group was 5.12 ± 1.60 days and that in the PILF group was 10.54 ± 1.82 days (P < 0.001). The VAS scores at postoperative 1 day, 3 months, 6 months, final follow‐up (Endo‐ULBD: 6.58 ± 0.65, 4.55 ± 0.54, 2.78 ± 0.24, 1.31 ± 0.78; PLIF: 7.19 ± 1.14, 4.80 ± 0.13, 2.71 ± 0.83, 1.29 ± 0.56) were significantly improved compared with those before surgery (Endo‐ULBD: 8.63 ± 0.37; PLIF: 8.31 ± 1.34). The ODI and EQ‐5D scores of lumbar function and quality of life at each time point after surgery (Endo‐ULBD ODI: 30.29% ± 0.47%, 23.35% ± 0.95%, 19.45% ± 0.81%, 10.84% ± 0.36%; EQ‐5D: 0.38 ± 0.15, 0.45 ± 0.17, 0.63 ± 0.14, 0.71 ± 0.20; PLIF ODI: 33.56% ± 1.58%, 25.69% ± 2.69%, 20.01% ± 1.49%, 10.72% ± 0.29%; EQ‐5D: 0.33 ± 0.03, 0.39 ± 0.05, 0.62 ± 0.07, 0.72 ± 0.10) were significantly improved compared with those before surgery (Endo‐ULBD: 44.56 ± 1.32, 0.33 ± 0.07; PLIF: 43.79 ± 1.91, 0.31 ± 0.09, respectively), with statistically significant differences (P < 0.05); however, there was no significant difference between the two groups at the last follow‐up (P > 0.05). At the last follow‐up, the excellent and good efficacy rate was 90.3% (28/31) in the Endo‐ULBD group and 89.4% (34/38) in the PILF group (χ2 = 0.089, P = 0.993). No mortality, irreversible nerve injury, or even paralysis occurred in either group. Endo‐ULBD for lumbar spinal stenosis has the advantages of less trauma, a shortened operation time, and rapid recovery and is an effective alternative for the treatment of lumbar spinal stenosis. Strict surgical...

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“…[1][2][3][4][5][6] There has been a substantial increase in the number of these types of procedures being carried out in ambulatory surgery centers. 7 The advantages of endoscopic transforaminal decompression are fewer postoperative complications, a shorter interval for return to work and social reintegration, 2,[8][9][10][11] less postoperative narcotic independence, and an overall reduced utilization of painkillers. 2,12 The latter problem is of significance in light of the opiate abuse epidemic in the United States, 13 more Copyright 2020 by International Society for the Advancement of Spine Surgery.…”

Section: Introductionmentioning

confidence: 99%

Reliability Analysis of Deep Learning Algorithms for Reporting of Routine Lumbar MRI Scans

Lewandrowski

Muraleedharan²,

Eddy³

et al. 2020

Int J Spine Surg

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Background: Artificial intelligence could provide more accurate magnetic resonance imaging (MRI) predictors of successful clinical outcomes in targeted spine care.Objective: To analyze the level of agreement between lumbar MRI reports created by a deep learning neural network (RadBot) and the radiologists' MRI reading.Methods: The compressive pathology definitions were extracted from the radiologist lumbar MRI reports from 65 patients with a total of 383 levels for the central canal: (0) no disc bulge/protrusion/canal stenosis, (1) disc bulge without canal stenosis, (2) disc bulge resulting in canal stenosis, and (3) disc herniation/protrusion/extrusion resulting in canal stenosis. For both, neural foramina were assessed with either (0) neural foraminal stenosis absent or (1) neural foramina stenosis present. Reporting criteria for the pathologies at each disc level and, when available, the grading of severity were extracted, and the Natural Language Processing model was used to generate a verbal and written report. The RadBot report was analyzed similarly as the MRI report by the radiologist. MRI reports were investigated by dichotomizing the data into 2 categories: normal and stenosis. The quality of the RadBot test was assessed by determining its sensitivity, specificity, and positive and negative predictive value as well as its reliability with the calculation of the Cronbach alpha and Cohen kappa using the radiologist MRI report as a gold standard.Results: The authors found a RadBot sensitivity of 73.3%, a specificity of 88.4%, a positive predictive value of 80.3%, and a negative predictive value of 83.7%. The reliability analysis revealed the Cronbach alpha as 0.772. The highest individual values of the Cronbach alpha were 0.629 and 0.681 when compared to the MRI report by the radiologist, rending values of 0.566 and 0.688, respectively. Analysis of interobserver reliability rendered an overall kappa for the RadBot of 0.627. Analysis of receiver operating characteristics (ROC) showed a value of 0.808 for the area under the ROC curve.Conclusions: Deep learning algorithms, when used for routine reporting in lumbar spine MRI, showed excellent quality as a diagnostic test that can distinguish the presence of neural element compression (stenosis) at a statistically significant level (P , .0001) from a random event distribution. This research should be extended to validated and directly visualized pain generators to improve the accuracy and prognostic value of the routine lumbar MRI scan for favorable clinical outcomes with intervention and surgery.

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Impact of occupational characteristics on return to work for employed patients after elective lumbar spine surgery

Cited by 38 publications

References 24 publications

Endoscopic discectomy as an effective treatment of a herniated intervertebral disc

Endoscopic discectomy as an effective treatment of a herniated intervertebral disc

Percutaneous Endoscopic Unilateral Laminotomy and Bilateral Decompression for Lumbar Spinal Stenosis

Reliability Analysis of Deep Learning Algorithms for Reporting of Routine Lumbar MRI Scans

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