The influence of comorbidities on the treatment outcome in symptomatic lumbar spinal stenosis: A systematic review and meta-analysis

Bays, Amandine; Stieger, Andrea; Held, Ulrike; Hofer, Lisa J; Rasmussen-Barr, Eva; Brunner, Florian; Steurer, Johann; Wertli, Maria M.

doi:10.1016/j.xnsj.2021.100072

Cited by 11 publications

(10 citation statements)

References 98 publications

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“…15,18,28 Possibly, worse baseline disability may be related to smaller improvement in disability after surgery as a continuous outcome, 52,64 but not as MCID. 54,65 Medical comorbidities are known to increase the risk of postoperative complications, 71,72 however, their effect on longer-term spinal surgery outcomes is less clear. 19,73 We found very low-quality evidence supporting significant associations between present comorbidities and smaller benefit from surgery in terms of reduction in pain, but not disability (low-quality).…”

Section: Health-related Predictorsmentioning

confidence: 99%

Predictors of Pain and Disability Outcomes Following Spinal Surgery for Chronic Low Back and Radicular Pain

Halicka¹,

Duarte²,

Catherall

et al. 2022

The Clinical Journal of Pain

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Objectives: Success rates of spinal surgeries to treat chronic back pain are highly variable and useable prognostic indicators are lacking. We aimed to identify and evaluate preoperative predictors of pain and disability after spinal surgery for chronic low back/ leg pain.Methods: Electronic database (01/1984-03/2021) and reference searches identified 2622 unique citations. Eligible studies included adults with chronic low back/leg pain lasting ≥ 3 months undergoing first elective lumbar spine surgery, and outcomes defined as change in pain (primary)/disability (secondary) after ≥ 3 months. We included 21 reports (6899 participants), 7 were judged to have low and 14 high risks of bias. We performed narrative synthesis and determined the quality of evidence (QoE).Results: Better pain outcomes were associated with younger age, higher education, and no spinal stenosis (low QoE); lower preoperative pain, fewer comorbidities, lower pain catastrophizing, anxiety and depression (very low QoE); but not with symptom duration (moderate QoE), other sociodemographic factors (low QoE), disability, or sensory testing (very low QoE). More favorable disability outcomes were associated with preoperative sensory loss (moderate QoE); lower job-related resignation and neuroticism (very low QoE); but not with socioeconomic factors, comorbidities (low QoE), demographics, pain, or pain-related psychological factors (very low QoE).Discussion: In conclusion, absence of spinal stenosis potentially predicts greater pain relief and preoperative sensory loss likely predicts reduction in disability. Overall, QoE for most identified associations was low/very low.

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Section: Health-related Predictorsmentioning

confidence: 99%

Predictors of Pain and Disability Outcomes Following Spinal Surgery for Chronic Low Back and Radicular Pain

Halicka¹,

Duarte²,

Catherall

et al. 2022

The Clinical Journal of Pain

View full text Add to dashboard Cite

show abstract

“…15,18,28 Possibly, worse baseline disability may be related to smaller improvement in disability after surgery as a continuous outcome, 52,64 but not as MCID. 54,65 Medical comorbidities are known to increase the risk of postoperative complications 71,72 ; however, their effect on longerterm spinal surgery outcomes is less clear. 19,73 We found very low-quality evidence supporting significant associations…”

Section: Limitationsmentioning

confidence: 99%

Predictors of Pain and Disability Outcomes Following Spinal Surgery for Chronic Low Back and Radicular Pain: A Systematic Review

Halicka¹,

Duarte²,

Catherall³

et al. 2022

Topics in Pain Management

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Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. This CME activity expires on June 30, 2024. NCPD AccreditationLippincott Professional Development is accredited as a provider of nursing continuing professional development (NCPD) by the American Nurses Credentialing Center's Commission on Accreditation. Lippincott Professional Development will award 3.5 contact hours for this NCPD activity. This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 3.5 contact hours. Lippincott Professional Development is also an approved provider of continuing nursing education by the District of Columbia,

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“…Microendoscopic procedures such as unilateral laminectomy bilateral decompression (ULBD) or interspinous decompression devices such as X-STOP are introduced as an alternative to laminectomy. 8 A study done to compare the outcome of laminoforaminotomy vs. laminectomy in lumbar spinal stenosis in terms of claudication distance showed that 15.2% of laminectomy and 5.6% of laminoforaminotomy patients have a poor outcome, while 75.8% and 83.3% have a good outcome in laminectomy and laminoforaminotomy group, respectively. Those having excellent outcomes were 9.1% in the laminectomy group and 11.1% in the laminoforaminotomy group.…”

Section: Introductionmentioning

confidence: 99%

The Outcome of Laminectomy versus Laminoforaminotomy in Terms of Claudication Distance in Lumbar Spinal Stenosis

Khan¹,

Javed²,

Ahemad³

et al. 2023

Pak J Neurol Surg

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Objectives: The study aimed to compare the surgical outcome of two different procedures for lumbar spinal stenosis. It helped us in the decision-making to go for less invasive procedures, as compared to conventional laminectomy in lumbar spinal stenosis patient patients. Materials and Methods: An interventional randomized controlled trial was conducted in the department of neurosurgery, Shaheed Zulfiqar Ali Bhutto Medical University, PIMS Islamabad. A total of 158 adult patients aged between 35 to 55 years with an established diagnosis of lumbar stenosis and claudication distance of fewer than 100 meters were enrolled. Patients were randomly included into two equal groups via the computerized method. In Group A laminectomy was done and in Group Blaminoforaminotomy was adopted. The outcome was measured in terms of claudication distance at 4 weeks after the procedure, and compared in both groups. Results: The mean age of the patients was 44.92 ± 6.28 years. Poor outcome was significantly lower in the Laminoforaminotomy group as compared to the Laminectomy group, at 4 weeks after the procedure. The frequency of claudication distance > 500m (good) at 4 weeks was found to be 62 (78.5%) in the Laminectomy group and it was found in 74 (93.7%) patients in the Laminoforaminotomy group (p = 0.022). Conclusions: The study concluded that the laminoforaminotomy is superior to laminectomy, in terms of claudication distance at four weeks after the procedure.

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The influence of comorbidities on the treatment outcome in symptomatic lumbar spinal stenosis: A systematic review and meta-analysis

Cited by 11 publications

References 98 publications

Predictors of Pain and Disability Outcomes Following Spinal Surgery for Chronic Low Back and Radicular Pain

Predictors of Pain and Disability Outcomes Following Spinal Surgery for Chronic Low Back and Radicular Pain

Predictors of Pain and Disability Outcomes Following Spinal Surgery for Chronic Low Back and Radicular Pain: A Systematic Review

The Outcome of Laminectomy versus Laminoforaminotomy in Terms of Claudication Distance in Lumbar Spinal Stenosis

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