Lumbar surgery prior to total hip arthroplasty is associated with worse patient-reported outcomes

Eneqvist, Ted; Nemes, Szilárd; Brisby, Helena; Fritzell, Peter; Garellick, Göran; Rolfson, Ola

doi:10.1302/0301-620x.99b6.bjj-2016-0577.r2

Cited by 74 publications

(52 citation statements)

References 30 publications

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“…We recently demonstrated that LBS prior to THR was associated with worse HRQol, more pain, and less satisfaction 1 year following THR . We found that time between surgeries did not influence outcomes, which is consistent with the present study.…”

Section: Discussionsupporting

confidence: 92%

“…To our knowledge, this and our previous work represent the first efforts to combine hip arthroplasty register data with spine register data. To answer the question of where to perform surgery first, we advise a follow‐up study investigating PROMs following THR and LBS, respectively, when there has also been previous surgery performed in the other location respectively within a relatively short period of time.…”

Section: Discussionmentioning

confidence: 98%

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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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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 98%

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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“…После дообследования пациентам диагностирован ОА ТБС [12,13] и проведено второе хирургическое вмешательство. В таких случаях итоговый результат оказался хуже, так как нейрохирургическое лечение пациентам исходно не требовалось [3]. Обратная ситуация, когда болевой синдром сохранялся после тотального эндопротезирования ТБС из-за недооценки вклада патологии поясничного отдела позвоночника, отмечалась в 29% случаев [8].…”

Section: Discussionunclassified

“…Основную сложность в диагностике КВС представляют выявление источника боли и последующий выбор метода лечения у пациентов, так как при неправильно выбранной тактике «первой операции» второе оперативное вмешательство зачастую имеет худшие результаты [3,4]. Жалобы на боль в ягодичной области, бедре, паху и/или области коленного сустава, иногда с нарушением походки, боль в поясничном отделе позвоночника являются типичными как для пациентов с ОА ТБС, так и для больных с дегенеративными изменениями поясничного отдела позвоночника [5].…”

unclassified

Optimization of Surgical Treatment Tactics for Patients With Hip-Spine Syndrome: A Clinical Case

Каргальцев¹,

Макаров²,

Амирджанова³

2019

Naučno-praktičeskaâ revmatologiâ

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Coexisting hip osteoarthritis (OA) and lumbar spinal stenosis (central and foraminal) and/or spondylolisthesis is called a hip-spine syndrome (HSS). The central problem is correctly diagnosing and determining the tactics of surgical or medical treatment for patients with HSS. The paper describes a clinical case of a female patient with HSS and an examination algorithm for determining the significance of peripheral neuropathy and hip OA and discusses the choice of surgical treatment tactics.

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“…Further, patients with improvement in LBP also had a significant difference in the amount of overall improvement (51.96 vs. 44.58, P < .000). Relatedly, a study assessing outcomes following hip arthroplasty reported worse pain (95% confidence interval [CI] 2.57 to 6.12), quality of life measures (95% CI ‐0.112 to −0.066) and satisfaction (95% CI 4.05 to 8.02) in patients who had previous lumbar spine surgery. As a whole, these studies suggest that overall, hip arthroplasty helps improve lumbar spine related pain and function …”

Section: Complex Subgroupmentioning

confidence: 99%

Links between the Hip and the Lumbar Spine (Hip Spine Syndrome) as they Relate to Clinical Decision Making for Patients with Lumbopelvic Pain

Prather

Dillen

2019

PM&R

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This narrative review focuses on the links between the hip and lumbar spine in the context of lumbopelvic pain. The literature regarding this topic is variable, found in many disciplines of care using different terminology. Collectively these inconsistencies add to the complexity of understanding the current evidence as it pertains to clinical practice. We have chosen to review studies that describe and assess overlapping pain distributions between the lumbar spine and hip, hip osteoarthritis and lumbopelvic pain, improvements in low back pain following hip arthroplasty, association of hip range of motion and lumbopelvic pain, and lumbopelvic motion and hip motion as they relate to low back pain and gender. The links between the hip and lumbar spine may provide the clinician important information to make decisions and recommendations for people presenting with the clinical symptom complex including lumbopelvic pain.

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Lumbar surgery prior to total hip arthroplasty is associated with worse patient-reported outcomes

Cited by 74 publications

References 30 publications

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

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

Optimization of Surgical Treatment Tactics for Patients With Hip-Spine Syndrome: A Clinical Case

Links between the Hip and the Lumbar Spine (Hip Spine Syndrome) as they Relate to Clinical Decision Making for Patients with Lumbopelvic Pain

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