Prognostic Factors for Surgical Outcomes Including Preoperative Total Knee Replacement and Knee Osteoarthritis Status in Female Patients With Lumbar Spinal Stenosis

Lee, Byung Ho; Kim, So Yeon; Chong, Hyun Soo; Lee, Seung Hwan; Park, Jin Oh; Kim, Hak-Sun; Shim, Dong Woo; Lee, Hwan Mo; Moon, Seong Hwan

doi:10.1097/bsd.0b013e31828d003d

Cited by 15 publications

(18 citation statements)

References 39 publications

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“…Consistent with our results, Ho et al reported that the presence of preoperative KOA was a poor prognostic factor for 1-year surgical outcomes of LSS. 11 However, because the past study used a single HRQOL parameter, the details of poor prognosis have remained unclear. In the present study, multiple HRQOL analysis revealed that the postoperative outcomes of the VAS for buttocks and lower limbs and SF-36 domains of physical functioning, role physical, and vitality were significantly worse in LSS patients with KOA than in LSS patients without KOA.…”

Section: Discussionmentioning

confidence: 99%

“…Ho Lee et al investigated surgical outcomes of LSS patients with or without KOA using the Oswestry Disability Index (ODI) and demonstrated that the presence of preoperative KOA was a poor prognostic factor for surgical outcomes of LSS. 11 However, because they assessed surgical outcomes using a single self-reported health-related quality of life (HRQOL) questionnaire, no definitive conclusions could be drawn. Therefore, by using multiple HRQOL parameters, this study aimed to investigate how the KOA condition affects the surgical outcome of lumbar spinal surgery for LSS patients.…”

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confidence: 99%

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Impact of knee osteoarthritis on surgical outcomes of lumbar spinal canal stenosis

Ozaki

Fujita

Miyamoto

et al. 2020

Journal of Neurosurgery: Spine

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OBJECTIVELumbar spinal canal stenosis (LSS) and knee osteoarthritis (KOA), both of which are age-related degenerative diseases, are independently correlated with increased pain and dysfunction of the lower extremities. However, there have been few studies that investigated whether LSS patients with KOA exhibit poor clinical recovery following lumbar spinal surgery. The aim of this study was to elucidate the surgical outcomes of lumbar spinal surgery for LSS patients with KOA using multiple health-related quality of life (HRQOL) parameters.METHODSA total of 865 consecutive patients who underwent posterior lumbar spinal surgery for LSS were retrospectively reviewed. Baseline characteristics, radiographic parameters, perioperative factors, and multiple HRQOL parameters were analyzed preoperatively and at 1-year follow-up. HRQOL items included the Zurich Claudication Questionnaire, Oswestry Disability Index, Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ). The effectiveness of surgical treatment was assessed using the JOABPEQ. The treatment was regarded as effective when it resulted in an increase in postoperative JOABPEQ score by ≥ 20 points compared with preoperative score or achievement of a postoperative score of ≥ 90 points in those with a preoperative score of < 90 points.RESULTSA total of 32 LSS patients with KOA were identified, and 128 age- and sex-matched LSS patients without KOA were selected as controls. In both groups, all HRQOL parameters markedly improved at the 1-year follow-up. On the SF-36, the postoperative mean score for the role physical domain was significantly lower in the KOA group than in the control group (p = 0.034). The treatment was significantly less “effective” in the social life domain of JOABPEQ in the KOA group than in the control group (p < 0.001).CONCLUSIONSThe surgical outcomes of LSS patients with KOA are favorable, although poorer than those of LSS patients without KOA, particularly in terms of social life and activities. These results indicate that LSS patients with KOA experience difficulty in routine work or ordinary activities due to knee pain or restricted knee ROM even after lumbar spinal surgery. Hence, preoperative KOA status warrants consideration when planning lumbar spinal surgery and estimating surgical outcomes of LSS.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Impact of knee osteoarthritis on surgical outcomes of lumbar spinal canal stenosis

Ozaki

Fujita

Miyamoto

et al. 2020

Journal of Neurosurgery: Spine

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“…In our study, the preoperative score of SRS pain and function significantly improved in both groups at the ultimate follow-up. However, group I showed [23], at postoperative 1 year, ODI scores were shown to be affected by the operational level, the preoperative ODI, and the presence of advanced radiographic knee OA (Kellgren/Lawrence grades III and IV) (P < 0.05). This phenomenon was also supported in the study of the relationship between clinical outcomes and sagittal radiographic parameters by Lafage et al [24].…”

Section: Discussionmentioning

confidence: 86%

Radiographic and clinical evidence: osteoarthritic knee can change surgical result for lumbar degenerative disease patient undergone surgery for 3-year follow-up: a retrospective comparative clinical study

Kim

et al. 2020

BMC Musculoskelet Disord

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Background There is a paucity of reports clarifying the implication of knee osteoarthritis (OA) on spinal sagittal alignment of patients undergone surgery for lumbar spine. This study aimed to analyze how osteoarthritic knee affects radiographic and clinical results of degenerative lumbar disease patients undergone lumbar fusion. Methods We retrospectively reviewed the medical records and radiographs of 74 consecutive degenerative lumbar disease patients who underwent posterior instrumentation and fusion surgery between May 2016 and June 2017 and were followed up for minimum 3 years postoperatively. The patients were divided into 2 groups according to the severity of knee OA by Kellgren-Lawrence grading (KLG) scale (group I, KLG 1 or 2 [n = 39]; group II, KLG 3 or 4 [n = 35]). Patient demographic data, comorbidities, spinal sagittal parameters and clinical scores were extracted and compared at preoperative, postoperative 1 month and the ultimate follow-up between the groups. In radiographic assessment, sagittal alignment parameters and sagittal balance were used. In clinical assessment, the scores of Oswestry disability index (ODI) and Scoliosis Research Society questionnaire (SRS-22) were used. For the frequency analysis of categorical variables across the groups, chi-square test was used and student t tests was used to compare the differences of continuous variables. Results In radiographic assessment, TLK (thoracolumbar kyphosis), LL (lumbar lordosis), PT (pelvic tilt), C7 SVA (sagittal vertical axis) in both groups improved significantly after surgery (p < 0.05). However, LL, PT, C7SVA improved at postoperative 1 month in the group II were not maintained at the ultimate postoperative follow-up. In clinical assessment, preoperative Oswestry disability index (ODI, %) and all SRS-22 subscores of the group I and II were not different (p > 0.05). There were significant differences between the groups at the ultimate follow-up in ODI (− 25.6 vs − 12.1, p < 0.001), SRS total score (%) (28 vs 20, p = 0.037), function subscore (1.4 vs 0.7, p = 0.016), and satisfaction subscore (1.6 vs 0.6, p < 0.001). Conclusion Osteoarthritic knee with KLG 3 or 4 have a negative influence on maintaining postoperative spinal sagittal alignment, balance, and the clinical outcomes achieved immediately by posterior instrumentation and fusion for lumbar degenerative disease. Trial registration This study was retrospectively registered with approval by the institutional review board (IRB) of our institution (approval number: 2018–11-007).

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“…These results indicate that clinical prognosis after spinal fusion surgery may be unfavorable if severe knee OA in patients exists concurrently. According to the report of Ho et al [23], at postoperative 1 year, ODI scores were shown to be affected by the operational level, the preoperative ODI, and the presence of advanced radiographic knee OA (Kellgren/Lawrence grades III and IV) (P<0.05). This phenomenon was also supported in the study of the relationship between clinical outcomes and sagittal radiographic parameters by Lafage et al [24].…”

Section: Discussionmentioning

confidence: 97%

Radiographic and Clinical Evidence: Osteoarthritic Knee Can Change Surgical Result for Lumbar Degenerative Disease Patient Undergone Surgery for 3-year Follow-up: A Retrospective Comparative Clinical Study

Kim

et al. 2020

Preprint

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Background : There is a paucity of reports clarifying the implication of knee osteoarthritis (OA) on spinal sagittal alignment of patients undergone surgery for lumbar spine. This study aimed to analyze how osteoarthritic knee affects radiographic and clinical results of degenerative lumbar disease patients undergone lumbar fusion. Methods : We retrospectively reviewed the medical records and radiographs of 74 consecutive degenerative lumbar disease patients who underwent posterior instrumentation and fusion surgery between May 2016 and June 2017 and were followed up for minimum 3 years postoperatively. The patients were divided into 2 groups according to the severity of knee OA by Kellgren-Lawrence grading (KLG) scale (group I, KLG 1 or 2 [n=39]; group II, KLG 3 or 4 [n=35]). Patient demographic data, comorbidities, spinal sagittal parameters and clinical scores were extracted and compared at preoperative, postoperative 1 month and the ultimate follow-up between the groups. In radiographic assessment, sagittal alignment parameters and sagittal balance were used. In clinical assessment, the scores of Oswestry disability index (ODI) and Scoliosis Research Society questionnaire (SRS-22) were used. For the frequency analysis of categorical variables across the groups, chi-square test was used and student t tests was used to assess the differences of continuous variables. Results : In radiographic assessment, TLK(thoracolumbar kyphosis), LL(lumbar lordosis), PT(pelvic tilt), C7 SVA(sagittal vertical axis) in both groups improved significantly after surgery(p<0.05). However, LL, PT, C7SVA improved at postoperative 1 month in the group II were not maintained at the ultimate postoperative follow-up. In clinical assessment, preoperative Oswestry disability index (ODI, %) and all SRS-22 subscores of the group I and II were not different (p>0.05). There were significant differences between the groups at the ultimate follow-up in ODI (-25.6 vs -12.1, p<0.001), SRS total score (%) (28 vs 20, p=0.037), function subscore (1.4 vs 0.7, p=0.016), and satisfaction subscore (1.6 vs 0.6, p<0.001). Conclusion: Osteoarthritic knee with KLG 3 or 4 have a negative influence on maintaining postoperative spinal sagittal alignment, balance, and the clinical outcomes achieved immediately by posterior instrumentation and fusion for lumbar degenerative disease.

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Prognostic Factors for Surgical Outcomes Including Preoperative Total Knee Replacement and Knee Osteoarthritis Status in Female Patients With Lumbar Spinal Stenosis

Cited by 15 publications

References 39 publications

Impact of knee osteoarthritis on surgical outcomes of lumbar spinal canal stenosis

Impact of knee osteoarthritis on surgical outcomes of lumbar spinal canal stenosis

Radiographic and clinical evidence: osteoarthritic knee can change surgical result for lumbar degenerative disease patient undergone surgery for 3-year follow-up: a retrospective comparative clinical study

Radiographic and Clinical Evidence: Osteoarthritic Knee Can Change Surgical Result for Lumbar Degenerative Disease Patient Undergone Surgery for 3-year Follow-up: A Retrospective Comparative Clinical Study

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