Lumbar spinal stenosis: Which predictive factors of favorable functional results after decompressive laminectomy?

Foulongne, E.; Derrey, Stéphane; Slimane, Mourad Ould; Lévêque, Stéphane; Tobenas, A.-C.; Dujardin, F.; Fréger, P.; Chassagne, Philippe; Proust, F.

doi:10.1016/j.neuchi.2012.09.005

Cited by 29 publications

(42 citation statements)

References 28 publications

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“…[1][2][3] Specific clinical outcome of spine surgery with fusion for degenerative lumbar spine conditions in 208 patients showed 62.5% satisfied, 19.7% partially satisfied, and 17.8% of patients dissatisfied. 4 Postsurgical continued pain (PSCP) sends patients to the offices of physicians, surgeons, and pain specialists alike in overwhelming numbers.…”

Section: Introductionmentioning

confidence: 99%

Chiropractic Distraction Spinal Manipulation on Postsurgical Continued Low Back and Radicular Pain Patients: A Retrospective Case Series

Gudavalli

Olding²,

Joachim

et al. 2016

Journal of Chiropractic Medicine

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Purpose: The purpose of this case series is to report on changes in pain levels experienced by 69 postsurgical continued pain patients who received Cox Technic Flexion Distraction (CTFD). Methods: Fifteen doctors of chiropractic collected retrospective data from the records of the postsurgical continued pain patients seen in their clinic from February to July 2012 who were treated with CTFD, which is a type of chiropractic distraction spinal manipulation. Informed consent was obtained from all patients who met the inclusion criteria for this study. Data recorded included subjective patient pain levels at the end of the treatments provided and at 24 months following the last treatment. Results: Fifty-four (81%) of the patients showed greater than 50% reduction in pain levels at the end of the last treatment, and 13 (19%) showed less than 50% improvement of pain levels at the end of active care (mean, 49 days and 11 treatments). At 24-month follow-up, of 56 patients available, 44 (78.6%) had continued pain relief of greater than 50% and 10 (18%) reported 50% or less relief. The mean percentage of relief at the end of active care was 71.6 (SD, 23.2) and at 24 months was 70 (SD, 25). At 24 months after active care, 24 patients (43%) had not sought further care, and 32 required further treatment consisting of chiropractic manipulation for 17 (53%), physical therapy, exercise, injections, and medication for 9 (28%), and further surgery for 5 (16%). Conclusion: Greater than 50% pain relief following CTFD chiropractic distraction spinal manipulation was seen in 81% of postsurgical patients receiving a mean of 11 visits over a 49-day period of active care.

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Section: Introductionmentioning

confidence: 99%

Chiropractic Distraction Spinal Manipulation on Postsurgical Continued Low Back and Radicular Pain Patients: A Retrospective Case Series

Gudavalli

Olding²,

Joachim

et al. 2016

Journal of Chiropractic Medicine

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“…5,11 In this study, we aimed to determine the specific preoperative prognostic factors associated with risk for reoperation in patients who have undergone a lumbar laminectomy. Smoking as an independent predictor of reoperation after lumbar laminectomy: a study of 500 cases obJect This study aimed to identify the factors predicting an increased risk for reoperation in patients who had undergone a lumbar laminectomy.…”

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confidence: 99%

Smoking as an independent predictor of reoperation after lumbar laminectomy: a study of 500 cases

Bydon

Macki

Ramos

et al. 2015

SPI

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OBJECT This study aimed to identify the factors predicting an increased risk for reoperation in patients who had undergone a lumbar laminectomy. METHODS The authors retrospectively reviewed the electronic medical records of all patients who had undergone firsttime, bilateral laminectomy at 1, 2, or 3 levels for lumbar spondylosis at the authors' institution. Patients who underwent fusion, laminotomy, discectomy, or complete facetectomy were excluded. The patients' preoperative symptoms and comorbidities were also obtained from their medical records. RESULTS Over an average follow-up period of 46.8 months, of 500 patients who had undergone laminectomy at 1, 2, or 3 levels, 81 patients (16.2%) developed subsequent spinal disorders that required a reoperation. A multiple logistic regression analysis identified smoking as an independent predictor of reoperation (OR 2.15, p = 0.01). Smoking was also an independent predictor of reoperation after a single-level laminectomy (OR 11.3, p = 0.02) and after a multilevel (that is, involving 2 or 3 levels) laminectomy (OR 1.98, p = 0.05). For 72 patients undergoing reoperation only for spinal degeneration, smoking remained an independent, statistically significant predictor of reoperation (OR 2.06, p = 0.04). Nine patients underwent reoperation for nondegenerative conditions (hematoma, wound infection, or wound dehiscence), and in these patients, chronic obstructive pulmonary disease was the only statistically significant predictor of reoperation (OR 8.92, p = 0.03). CONCLUSIONS Smoking was the strongest predictor of reoperation in patients who had undergone single-level laminectomy, multilevel laminectomy, or reoperation for progression of spinal degeneration. These findings suggest that smokers have worse outcomes of lumbar decompression than nonsmokers.

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“…Other studies have similarly reported worse results following LBS in the presence of comorbidities affecting walking ability . In a prospective study of 98 patients operated with decompressive lumbar laminectomy for spinal stenosis, Foulongne et al demonstrated that low Charlson comorbidity index scores was the strongest predictor of favorable functional outcomes.…”

Section: Discussionmentioning

confidence: 97%

“…There are several studies reporting worse outcomes following LBS if there is a preoperative disorder affecting the patients walking capacity, such as hip osteoarthritis . Conversely, absence of comorbidities (as measured by Charlson comorbidity index) and mobility disorders positively influence the outcomes of LBS …”

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confidence: 99%

Patients with a previous total hip replacement experience less reduction of back pain following lumbar back surgery

Eneqvist

Bülow

Nemes

et al. 2018

Journal Orthopaedic Research

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The coexistence of degenerative disorders from the hip joint and the lumbar spine, known as "the hip-spine syndrome," is a common encounter in clinical practice. These degenerative conditions may cause similar symptoms which often entail diagnostic challenges in determining the origin of pain. Lumbar back surgery (LBS) with fusion and/or decompression, and total hip replacement (THR) are both often successful interventions. However, the knowledge is limited about the post-operative patient-reported outcome (PRO) following LBS in the presence of a prior THR. The aims of this study were to compare 1-year post-operative patient-reported outcome measures (PROMs) following lumbar back surgery (LBS) in patients with and without a prior total hip replacement (THR). Data from Swespine and the Swedish Hip Arthroplasty Register were linked in order to identify the study group of patients with THR prior to LBS. The study group (n = 220) and a matched control group (n = 220) with isolated LBS was defined by using a step-wise selection process. Linear- and logistic regression analyses adjusted for age, sex and pre-operative PROMs demonstrated that THR prior to LBS was associated with worse back-pain (VAS) at 1-year follow-up (B = 5.3, 95%CI: 0.3;10.3). However, previous THR did not influence the EQ-5D index (B = 0.01, 95%CI: -0.05;0.06), EQ VAS (B = -3.0, 95%CI: -6.9;1.0), leg pain (B = 1.5, 95%CI: -4.0;7.0), Oswestry Disability Index (B = 2.6, 95%CI: -0.5;5.6) or satisfaction (OR = 1.1, 97.5%CI 0.7;1.6). This knowledge is important to communicate prior to LBS in order to set proper expectations on surgical outcomes. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2484-2490, 2018.

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Lumbar spinal stenosis: Which predictive factors of favorable functional results after decompressive laminectomy?

Abstract: The long-term results of surgical treatment of lumbar spinal stenosis were moderate with an improved outcome in 49.5% of cases in our study. The only independent factor to a favorable outcome was the low comorbidity.

Cited by 29 publications

References 28 publications

Chiropractic Distraction Spinal Manipulation on Postsurgical Continued Low Back and Radicular Pain Patients: A Retrospective Case Series

Chiropractic Distraction Spinal Manipulation on Postsurgical Continued Low Back and Radicular Pain Patients: A Retrospective Case Series

Smoking as an independent predictor of reoperation after lumbar laminectomy: a study of 500 cases

Patients with a previous total hip replacement experience less reduction of back pain following lumbar back surgery

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