Preoperative Predictors of Better Long-term Functional Ability and Decreased Pain Following LSS Surgery

Abstract

Study design A prospective observational 10-year follow-up studyObjective This study aimed to examine preoperative predictors for better surgical outcomes in patients with lumbar spinal stenosis (LSS) 10 years after surgery. Summary of Background DataLSS is a leading cause of low back surgery in patients older than 65 years. Limited data is available for predictors of long-term surgical outcomes in patients with LSS. Methods At the baseline, 102 patients with LSS underwent decompressive surgery, and 72 of the original study sample participated in a 10-year follow-up study. Study patients filled out a questionnaire preoperatively, and follow-up data were collected at 3 months, 6 months, 1 year, 2 years, 5 years, and 10 years postoperatively. Surgical outcomes were evaluated in terms of disability with the Oswestry Disability Index (ODI) and pain with the visual analog scale (VAS).Predictors in the models were non-smoking status, absence of previous lumbar surgery, self-rated health, regular use of painkillers for symptom alleviation, and BMI. Statistical analyses included longitudinal associations, subgroup analyses, and cross-sectional analyses.Results Using multivariate analysis, statistically significant predictors for lower ODI and VAS scores at 10 years were non-smoking status, absence of previous lumbar surgery, better self-rated health, and regular use of painkillers for less than 12 months. Patients who smokedCopyright © 2020 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.preoperatively or had previous lumbar surgery experienced more pain and disability at the 10year follow-up. ConclusionThese study results can enhance informed decision-making processes for patients considering surgical treatment for LSS by showing preoperative predictors for surgical outcomes up to 10 years after surgery. Smokers and patients with previous lumbar surgery showed a decline in surgical benefits after five years.

Delta large-channel technique versus microscopy-assisted laminar fenestration decompression for lumbar spinal stenosis: a one-year prospective cohort study

“…It is currently reported that most studies reporting the postoperative clinical effects of LSS are focused on improving postoperative radiative pain, whereas few studies report improvements in postoperative numbness [25][26][27][28][29]. Typically, patients experience significant pain relief after lumbar decompression surgery, but the sensation of numbness does not improve as much as they might expect.…”

Influencing Factors for Choosing Korean Medicine Treatments after Spinal Surgery or Spinal Surgery Recommendation in Patients with Spinal Pain: A Semi-Structured Interview Study

“…According to past studies, patients tend to have more optimistic expectations for postoperative symptom improvement rather than the actual surgical outcome [9] and often expect their symptoms to be completely resolved after surgery [10]. However, even after spinal surgery, some degree of pain and functional impairment remain, and some patients experience adverse events [23][24][25]. This disjunction between expectations and reality can be explained as a result of the lack of information given to the patients.…”

Correlation analysis between the changes in the root canal area and the intervertebral foramen cross-sectional area and the relevant scores of clinical symptom improvement in patients with unilateral L4-L5 spinal stenosis after MIS-TLIF

“…Though MIS-TLIF has only been in use for a relatively short period, it has demonstrated comparable, and sometimes superior, surgical outcomes compared to traditional open surgery. It offers advantages such as reduced trauma and fewer complications [17,18]. MIS-TLIF creates an expandable traction channel through a small incision, preserving the posterior ligament complex (PLC) structure, thus maximizing posterior structural stability [19].…”