Prognostic factors in lumbar spinal stenosis surgery

Sigmundsson, F.; Kang, Xiao P; Jönsson, Bo; Strömqvist, Björn

doi:10.3109/17453674.2012.733915

Cited by 67 publications

(79 citation statements)

References 33 publications

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“…Sigmundsson et al found in their prospective study that a smaller dural sac area predicted less leg pain postoperatively and more pain relief for LBP. However, they did not visually evaluate the severity of LSS, and walking distance was only subjectively estimated by the patient, depressive symptoms were not adjusted, and the clinical outcome was only evaluated with a one-year follow-up [20]. Our results are generally in line with these studies, i.e.…”

Section: Discussionsupporting

confidence: 83%

“…Sigmundsson et al investigated the predictive value of MRI findings among a study population consisting of 109 LSS patients undergoing surgery with a one-year follow-up. They found in their prospective study that a smaller dural sac area predicted less leg pain postoperatively and more pain relief in low LBP [20]. None of these studies have, however, investigated the predictive value of visual and quantitative findings from preoperative lumbar spine MR images for both subjective and objective clinical outcome measures with a two-year follow-up [19], [20].…”

Section: Introductionmentioning

confidence: 99%

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Preoperative MRI Findings Predict Two-Year Postoperative Clinical Outcome in Lumbar Spinal Stenosis

et al. 2014

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PurposeTo study the predictive value of preoperative magnetic resonance imaging (MRI) findings for the two-year postoperative clinical outcome in lumbar spinal stenosis (LSS).Methods84 patients (mean age 63±11 years, male 43%) with symptoms severe enough to indicate LSS surgery were included in this prospective observational single-center study. Preoperative MRI of the lumbar spine was performed with a 1.5-T unit. The imaging protocol conformed to the requirements of the American College of Radiology for the performance of MRI of the adult spine. Visual and quantitative assessment of MRI was performed by one experienced neuroradiologist. At the two-year postoperative follow-up, functional ability was assessed with the Oswestry Disability Index (ODI 0–100%) and treadmill test (0–1000 m), pain symptoms with the overall Visual Analogue Scale (VAS 0–100 mm), and specific low back pain (LBP) and specific leg pain (LP) separately with a numeric rating scale from 0–10 (NRS-11). Satisfaction with the surgical outcome was also assessed.ResultsPreoperative severe central stenosis predicted postoperatively lower LP, LBP, and VAS when compared in patients with moderate central stenosis (p<0.05). Moreover, severe stenosis predicted higher postoperative satisfaction (p = 0.029). Preoperative scoliosis predicted an impaired outcome in the ODI (p = 0.031) and lowered the walking distance in the treadmill test (p = 0.001). The preoperative finding of only one stenotic level in visual assessment predicted less postoperative LBP when compared with patients having 2 or more stenotic levels (p = 0.026). No significant differences were detected between quantitative measurements and the patient outcome.ConclusionsRoutine preoperative lumbar spine MRI can predict the patient outcome in a two-year follow up in patients with LSS surgery. Severe central stenosis and one-level central stenosis are predictors of good outcome. Preoperative finding of scoliosis may indicate worse functional ability.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Preoperative MRI Findings Predict Two-Year Postoperative Clinical Outcome in Lumbar Spinal Stenosis

et al. 2014

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“…In the remaining 29 studies, patient characteristics were used as covariates, varying from 17 predefined covariates ( Royuela et al 2014 ) to adjustment for baseline PROMs only ( Solberg et al 2013 ). Adjustment for baseline PROMs was not performed in 8 studies ( Deer et al 2004 , Bridwell et al 2007 , Glassman et al 2009 , Zweig et al 2011 , Kovacs et al 2012 , Sigmundsson et al 2012 , McGirt et al 2013 , Adogwa et al 2014 ). In 8 studies, a dropout analysis was performed to compare baseline characteristics (missing data on assessment) with the remaining cases.…”

Section: Resultsmentioning

confidence: 99%

Evidence and practice in spine registries

Hooff¹,

Jacobs

Willems

et al. 2015

Acta Orthopaedica

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Background and purpose We performed a systematic review and a survey in order to (1) evaluate the evidence for the impact of spine registries on the quality of spine care, and with that, on patient-related outcomes, and (2) evaluate the methodology used to organize, analyze, and report the “quality of spine care” from spine registries.Methods To study the impact, the literature on all spinal disorders was searched. To study methodology, the search was restricted to degenerative spinal disorders. The risk of bias in the studies included was assessed with the Newcastle-Ottawa scale. Additionally, a survey among registry representatives was performed to acquire information about the methodology and practice of existing registries.Results 4,273 unique references up to May 2014 were identified, and 1,210 were eligible for screening and assessment. No studies on impact were identified, but 34 studies were identified to study the methodology. Half of these studies (17 of the 34) were judged to have a high risk of bias. The survey identified 25 spine registries, representing 14 countries. The organization of these registries, methods used, analytical approaches, and dissemination of results are presented.Interpretation We found a lack of evidence that registries have had an impact on the quality of spine care, regardless of whether intervention was non-surgical and/or surgical. To improve the quality of evidence published with registry data, we present several recommendations. Application of these recommendations could lead to registries showing trends, monitoring the quality of spine care given, and ultimately improving the value of the care given to patients with degenerative spinal disorders.

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“…Second, we did not evaluate the duration of symptoms before surgery. Previous studies showed that duration of symptoms was associated with the clinical outcomes or PS 3,12,[19][20][21] ; however, some reviews have reported no association. 22,23 LSS symptoms are usually episodic, and patients do not always remember the onset.…”

Section: Discussionmentioning

confidence: 95%

Factors Influencing Patient Satisfaction After Decompression Surgery Without Fusion for Lumbar Spinal Stenosis

Ogura

Kobayashi

Shinozaki

et al. 2019

Global Spine Journal

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Study Design: Retrospective cohort study. Objectives: Decompression without fusion is a standard surgical treatment for lumbar spinal stenosis (LSS) with reasonable surgical outcomes. Nevertheless, some studies have reported low patient satisfaction (PS) following decompression surgery. The cause of the discrepancy between reasonable clinical outcomes and PS is unknown; moreover, the factors associated with PS are expected to be complex, and little is known about them. This study aimed to identify satisfaction rate and to clarify the factors related to PS following decompression surgery in LSS patients. Methods: We retrospectively reviewed 126 patients who underwent lumbar decompression with a minimum follow-up of 1 year. Patients were divided into 2 groups based on the PS question. The Japanese Orthopaedic Association (JOA) scores, and the Numeric Rating Scale (NRS) scores of low back pain (LBP), leg pain, and leg numbness were compared between the 2 groups preoperatively and at the latest visit. To identify the prognostic factors for dissatisfaction, multiple logistic regression analysis was performed. Results: Overall satisfaction rate was 75%. The JOA recovery rate, NRS improvement, and Short Form–8 (SF-8) were significantly higher in the satisfied group. Postoperative NRS scores of LBP, leg pain, and leg numbness were significantly lower in the satisfied group. Multivariate logistic regression analysis showed that smoking and scoliosis were significant risk factors for dissatisfaction. Conclusions: Overall satisfaction rate was 75% in patients with LSS undergoing decompression surgery. This study found that smoking status and scoliosis were associated with patient dissatisfaction following decompression in LSS patients.

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Prognostic factors in lumbar spinal stenosis surgery

Cited by 67 publications

References 33 publications

Preoperative MRI Findings Predict Two-Year Postoperative Clinical Outcome in Lumbar Spinal Stenosis

Preoperative MRI Findings Predict Two-Year Postoperative Clinical Outcome in Lumbar Spinal Stenosis

Evidence and practice in spine registries

Factors Influencing Patient Satisfaction After Decompression Surgery Without Fusion for Lumbar Spinal Stenosis

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