Clinical and Radiological Study Focused on Relief of Low Back Pain After Decompression Surgery in Selected Patients With Lumbar Spinal Stenosis Associated With Grade I Degenerative Spondylolisthesis

Ikuta, Kentaro; Masuda, Kentaro; Tominaga, Fuyuki; Sakuragi, Takahide; Kai, Kazuhiro; Kitamura, Takahiro; Senba, Hideyuki; Shidahara, Satoshi

doi:10.1097/brs.0000000000001813

Cited by 21 publications

(19 citation statements)

References 43 publications

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“…A few different means of decompression surgeries were featured among the studies, with laminectomy and laminotomy being the most commonly performed. [14][15][16][17][18][19][20][21][22][23][24] One study assessed laminoplasty, 17 and 1 study assessed semi-circumferential decompression. 25 In 5 of the fusion studies, patients underwent un-instrumented posterolateral fusion, 15,17,21,22,26 and in the remaining fusion studies, some form of interbody fusion was used.…”

Section: Methodsmentioning

confidence: 99%

Decompression Versus Fusion for Grade I Degenerative Spondylolisthesis: A Meta-Analysis

Koenig

Jauregui

Shasti

et al. 2018

Global Spine Journal

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Study Design: Meta-analysis of evidence level I to IV studies. Objective: To compare decompression alone versus decompression plus fusion in the treatment of grade I degenerative spondylolisthesis (DS). Methods: Following established guidelines, we systematically reviewed 3 electronic databases to assess studies evaluating patients with grade I DS. We stratified all patients into 2 cohorts; the first cohort underwent a decompression-type surgery, and the second cohort underwent decompression plus fusion. We noted clinical outcomes, complications, reoperations, and surgical details such as blood loss. Descriptive statistics and random-effects models were used to determine the specified outcome metrics with 95% confidence intervals (CIs). Results: In both cohorts, the pain (legs and lower back) significantly decreased and the physical component of the Short Form 36 showed better patient clinical outcomes. The decompression cohort had a 5.8% complication rate (95% CI = 1.7-2.1), and the decompression plus fusion cohort had an 8.3% complication rate (95% CI = 5.5-11.6). The reoperation rate was higher in the decompression-only cohort (8.5%; 95% CI = 2.9-17.0) compared with the decompression plus fusion cohort (4.9%; 95% CI = 2.5-7.9). Conclusions: There does not appear to be any advantage of one procedure over the other. Patients undergoing decompression alone tended to be older with a higher percentage of leg pain, whereas patients additionally undergoing fusion tended to be younger with more lower back pain. The decompression-only cohort had fewer complications but a higher revision rate.

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Section: Methodsmentioning

confidence: 99%

Decompression Versus Fusion for Grade I Degenerative Spondylolisthesis: A Meta-Analysis

Koenig

Jauregui

Shasti

et al. 2018

Global Spine Journal

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“…A similar study documented patients' improvement in terms of physical progress [9]. Corresponding studies also show positive outcomes considering both the lower back pain and pain in the feet [10]. Previous studies further confirm that the patient's outcome after surgery is considered to be superior to conservative treatment [1].…”

Section: Introductionmentioning

confidence: 68%

Patients’ Perceptions Of Lumbar Spinal Stenosis And Experiences After Surgical Treatment

Bakke¹,

Kvangarsnes²,

Sagen³

et al. 2019

Preprint

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PURPOSE: Research has shown that surgery gives patients with lumbar spinal stenosis health advantages compared to conservative treatment. This qualitative study aimed to investigate the perception of symptoms from lumbar spinal stenosis by patients, and their experiences after surgery. The purpose was to create a comprehensive understanding of patients’ experiences before and after treatment. METHOD: We chose purposive sampling and conducted ten semi-structured interviews in early 2018. Thematic analysis was adopted. RESULTS: The patients stated that a strong and constant pain characterized their life situation before the operation. After surgery, the patients experienced rapid recovery from pain. The patients stated that the pain had led to considerable functional limitations. After surgery, they experienced remarkable improvement on a functional level. The patients shared their experience about how pain had prevented them from participating in meaningful activities and tasks. Some of the patients said that they had experienced depression due to the difficult situation before surgery. The patients found that treatment led to an improvement in their quality of life. CONCLUSION: The study showed that the patients who lived with severe symptoms of lumbar spinal stenosis experienced a decline in their quality in life. The condition prevented them from participating in daily activities. After surgery, they were able to participate in meaningful activities and tasks. They felt an increased participation in society. Social support and information from health care providers enables patients to make knowlege-based choises.

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“…[2][3][4][5] However, the mechanism causing LBP in LSS is not yet clear. 6 Although a few studies have shown improvements of LBP as well as leg symptoms by decompression surgery, [6][7][8] we have observed patients suffering for LBP after decompression surgery without fusion. Evidence suggesting that LBP in LSS is improved by decompression surgery is lacking, and the predicting factor for postoperative residual LBP is unknown.…”

Section: Introductionmentioning

confidence: 81%

“…Flat-back and limited lumbar mobility were shown to be risk factors for residual LBP. 8 Ikuta et al 7 reported that increased LL and SS, and decreased PT after decompression surgery were observed in their LBP improvement group. Additionally, other retrospective studies showed that preoperative and postoperative SVA values were correlated with LBP.…”

Section: Predictive Factor For Residual Lbpmentioning

confidence: 94%

“…Many authors have tried to determine predicting factors for residual LBP after decompression surgery without fusion in LSS. 5,7,8,22,23 A retrospective study performed in Japan showed significant differences in LL and lumbar range of motion by preoperative radiographs. Flat-back and limited lumbar mobility were shown to be risk factors for residual LBP.…”

Section: Predictive Factor For Residual Lbpmentioning

confidence: 99%

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Improvement of Lower Back Pain in Lumbar Spinal Stenosis After Decompression Surgery and Factors That Predict Residual Lower Back Pain

Kitagawa

Ogura

Kobayashi

et al. 2020

Global Spine Journal

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Study Design: Retrospective observational study. Objectives: There is no consensus to predict improvement of lower back pain (LBP) in lumbar spinal stenosis after decompression surgery. The aim of this study was to evaluate the improvement of LBP and analyze the preoperative predicting factors for residual LBP. Methods: We retrospectively reviewed 119 patients who underwent lumbar decompression surgery without fusion and had a minimum follow-up of 1 year. LBP was evaluated using the numerical rating scale (NRS), Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) LBP score, and Roland-Morris Disability Questionnaire (RMDQ). All patients were divided into LBP improved group (group I) and LBP residual group (group R) according to the NRS score. Radiographic images were examined preoperatively and at the final follow-up. We evaluated spinopelvic radiological parameters and analyzed the differences between group I and group R. Results: LBP was significantly improved after decompression surgery (LBP NRS, 5.7 vs 2.6, P < .001; JOABPEQ LBP score, 41.3 vs 79.6, P < .001; RMDQ, 10.3 vs 3.6, P < .001). Of 119 patients, 94 patients were allocated to group I and 25 was allocated to group R. There was significant difference in preoperative thoracolumbar kyphosis between group I and group R. Conclusions: Most cases of LBP in lumbar spinal stenosis were improved after decompression surgery without fusion. Preoperative thoracolumbar kyphosis predicted residual LBP after decompression surgery.

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Clinical and Radiological Study Focused on Relief of Low Back Pain After Decompression Surgery in Selected Patients With Lumbar Spinal Stenosis Associated With Grade I Degenerative Spondylolisthesis

Abstract: 3.

Cited by 21 publications

References 43 publications

Decompression Versus Fusion for Grade I Degenerative Spondylolisthesis: A Meta-Analysis

Decompression Versus Fusion for Grade I Degenerative Spondylolisthesis: A Meta-Analysis

Patients’ Perceptions Of Lumbar Spinal Stenosis And Experiences After Surgical Treatment

Improvement of Lower Back Pain in Lumbar Spinal Stenosis After Decompression Surgery and Factors That Predict Residual Lower Back Pain

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