LumbSten: The lumbar spinal stenosis outcome study

Abstract

BackgroundLumbar spinal stenosis is the most frequent reason for spinal surgery in elderly people. For patients with moderate or severe symptoms different conservative and surgical treatment modalities are recommended, but knowledge about the effectiveness, in particular of the conservative treatments, is scarce. There is some evidence that surgery improves outcome in about two thirds of the patients. The aims of this study are to derive and validate a prognostic prediction aid to estimate the probability of clinically relevant improvement after surgery and to gain more knowledge about the future course of patients treated by conservative treatment modalities.Methods/DesignThis is a prospective, multi-centre cohort study within four hospitals of Zurich, Switzerland. We will enroll patients with neurogenic claudication and lumbar spinal stenosis verified by Computer Tomography or Magnetic Resonance Imaging. Participating in the study will have no influence on treatment modality. Clinical data, including relevant prognostic data, will be collected at baseline and the Swiss Spinal Stenosis Questionnaire will be used to quantify severity of symptoms, physical function characteristics, and patient's satisfaction after treatment (primary outcome). Data on outcome will be collected 6 weeks, and 6, 12, 24 and 36 months after inclusion in the study. Applying multivariable statistical methods, a prediction rule to estimate the course after surgery will be derived.DiscussionThe ultimate goal of the study is to facilitate optimal, knowledge based and individualized treatment recommendations for patients with symptomatic lumbar spinal stenosis.

Could Less Be More When Assessing Patient-Rated Outcome in Spinal Stenosis?

“…34 The 12-month return rate was higher for the COMI than for the booklet containing the SSM and other questionnaires, although comparable efforts were made to obtain each of them. However, whether this was a function of the brevity of the COMI questionnaire or the added obligations of being in the observational cohort study 19 is not known. This study was not without its limitations.…”

“…Patients (N = 91; Table 1) were from a single center, in the surgical arm of a multicenter prospective cohort study evaluating outcomes after surgical and conservative treatment of central spinal stenosis (explained in detail in Steurer et al 19 ). The main inclusion criteria were age more than 50 years; uni-/ bilateral neurogenic claudication; verified diagnosis of spinal stenosis upon imaging; and ability to complete questionnaires in German.…”

“…19 scores and the GTO and the SSM-sat scores 12 months postoperatively (using the scores on the 5-and 4-point scales, respectively) was also examined. It was hypothesized that correlation coefficients for all these relationships, if the variables were measuring similar attributes, would range from 0.4 to 0.8.…”

The Effect of Epidural Steroid Injection on Postoperative Outcome in Patients From the Lumbar Spinal Stenosis Outcome Study

“…The aim of this study is to report the clinical outcome after surgical or nonoperative treatment in patients participating in the Lumbar Spinal Stenosis Outcome Study (LSOS) 13 who either did or did not receive an ESI within the 12 months prior to enrollment.…”

Effect of Integrated Exercise Protocol in Lumbar Spinal Stenosis as Compare with Conventional Physiotherapy- A Randomized Control Trial

“…MRI or CT scan is widely used diagnostic tools which confirm the presence of spinal stenosis [12]. The Radiological criteria for lumbar spinal stenosis (L1 to L5) according to location of the stenosis through MRI [13].…”