Background: Lumbar Canal Stenosis (LCS) is the most common reason for spinal surgery in older patients. Identifying factors influencing the outcome of surgical management is important in clinical research. Objectives: This study aims to identify the factors affecting the outcome of surgical management for LCS. Materials & Methods: This prospective non-randomized cohort study was conducted at the spine center of Imam Khomeini Hospital in Tehran, Iran from March 2017 to January 2019 on 135 patients with symptomatic LCS, confirmed by MRI. Clinical and functional outcomes were measured using the 12-Item Short form Health Survey (SF-12), Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) the day before surgery, and 12 and 24 months after surgery. Radiographical parameters was assessed by measuring lumbar lordosis, sacral slope, pelvic tilt and pelvic incidence. Results: Of 135 patients, 120 completed the follow-up. Patients treated surgically had significantimprovement in SF-12, ODI and VAS scores after 2 years of follow-up. Higher values of BMI(P=0.031), symptom duration >1 year (P=0.045 for SF-12, P=0.031 for ODI), and smoking(P=0.033 for SF-12, P=0.028 for ODI) were associated with poor outcome. Patients with higher pre-operative SF-12, ODI and VAS scores (P=0.007 for SF-12, P=0.003 for ODI, P=0.050 for VAS) and lower lumbar lordosis (P=0.055) showed significant improvement after surgery. Conclusion: Patients with LCS showed significant improvement in outcomes afterdecompression surgery. Higher values of BMI, symptom duration >1 year, and smokingare associated with poor outcome, while higher pre-operative disability score and lowerlumbar lordosis are associated with better outcome after surgery.

Background: Calculation of the risk of instability and malunion in patients with distal radius fracture and choosing treatment based on this risk percentage is a new method that can greatly help surgeons in decision-making. In this study, we have tried to make a comparison between treatment decision-making based on prediction of the risk of instability and experience of orthopedic surgeons for management of this fracture. Methods: Recorded information of 69 patients with extra-articular distal radius fracture diagnosis was examined. Radiographs and age of each patient were submitted to two orthopedic surgery professors and they were asked to express their opinion about surgical or non-surgical treatment for each patient based on their own personal habit. The risk of instability was calculated for each patient and surgical or non-surgical treatment for each patient was proposed based on this risk percentage with cut-off point of 70%. Then, the treatment proposed by each surgeon was compared with the treatment proposed based on the calculated risk of instability. Results: The study demonstrated that treatment decision-making for distal radius fracture according to the risk of instability with cut-off point of 70% (this is surgery for fractures with instability risk of more than 70% versus non-surgical intervention for cases with risk of less than 70%) is not significantly and reliably consistent with the opinions of two orthopedic surgeons who had the experience of confronting this fracture. Conclusions: Prediction of the risk of instability for management of distal radius fracture needs to be validated through further studies before being used as the decisive factor for management of this fracture. Colleagues are invited to assess the outcomes of using the risk of instability more accurately with further studies. It is suggested to be more prudent and perform more evaluations when the risk of instability calculation with cut-off point of 70% is used to choose the appropriate treatment.