Surgical Outcome of 438 Patients Treated Surgically for Lumbar Spinal Stenosis

Airaksinen, Olavi; Herno, Arto; Turunen,; Saari, Tapani; Suomlainen, O

doi:10.1097/00007632-199710010-00016

Cited by 235 publications

(178 citation statements)

References 17 publications

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“…The finding that gender, BMI, previous back surgery, leg pain intensity, comorbidities, pain in the thoracic spine, somatization, treatment expectations, and walking distance were predictive of spinal surgery referral is in line with previous studies showing that they are also indicative of spinal surgery outcome [12,[19][20][21][22][23]. This can be interpreted as that surgeons are aware of and adhere to some extent to the current literature and (international) guidelines.…”

Section: Comparison With the Literaturesupporting

confidence: 88%

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Which patient-reported factors predict referral to spinal surgery? A cohort study among 4987 chronic low back pain patients

et al. 2017

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Purpose It is unknown which chronic low back pain (CLBP) patients are typically referred to spinal surgery. The present study, therefore, aimed to explore which patient-reported factors are predictive of spinal surgery referral among CLBP patients. Methods CLBP patients were consecutively recruited from a Dutch orthopedic hospital specialized in spine care (n = 4987). The outcome of this study was referral to spinal surgery (yes/no), and was assessed using hospital records. Possible predictive factors were assessed using a screening questionnaire. A prediction model was constructed using logistic regression, with backwards selection and p \ 0.10 for keeping variables in the model. The model was internally validated and evaluated using discrimination and calibration measures.Results Female gender, previous back surgery, high intensity leg pain, somatization, and positive treatment expectations increased the odds of being referred to spinal surgery, while being obese, having comorbidities, pain in the thoracic spine, increased walking distance, and consultation location decreased the odds. The model's fit was good (X 2 = 10.5; p = 0.23), its discriminative ability was poor (AUC = 0.671), and its explained variance was low (5.5%). A post hoc analysis indicated that consultation location was significantly associated with spinal surgery referral, even after correcting for case-mix variables. Conclusion Some patient-reported factors could be identified that are predictive of spinal surgery referral. Although the identified factors are known as common predictive factors of surgery outcome, they could only partly predict spinal surgery referral.

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Section: Comparison With the Literaturesupporting

confidence: 88%

“…On the contrary, CLBP patients with comorbidities were found to be less likely to be referred to surgery than those without comorbidities. This too suggests that the surgeons referred in line with the current scientific evidence, as comorbidities are an important risk factor for surgery [12,19,21,22].…”

Section: Comparison With the Literaturementioning

confidence: 71%

Which patient-reported factors predict referral to spinal surgery? A cohort study among 4987 chronic low back pain patients

et al. 2017

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“…Many spinal interventions appear to have excellent early post-operative results [2,3,14,40], but there is a temporal decline in benefit [21,35,41]. This would then indicate that conservative options may provide a viable option.…”

Section: Introductionmentioning

confidence: 99%

The outcome of spinal decompression surgery 5 years on

2007

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Decompression surgery is an increasingly common operation for the treatment of lumbar spinal stenosis. Although good relief from leg pain is expected after surgery, long term results of pain relief and function are more uncertain. This study prospectively followed a cohort of patients presenting with the signs and symptoms of spinal stenosis, who underwent decompression surgery to ascertain the long term outcome with respect to pain and function using visual analogue pain scores, the Oswestry Disability Index, and the Short Form 36, a general health questionnaire. From an initial pool of 84 recruited patients, 7 withdrew from surgical intervention; of the remaining 77, 51 (66%) returned for follow up assessments at 5 years. In these responders, a significant improvement was observed in back and leg pain, which was sustained for at least 1 year (P < 0.01). A significant improvement was also seen in physical function (P < 0.05) as assessed by Oswestry and SF-36. Although an initial improvement was noted in social function, this was not observed at 5 years. This study has demonstrated that decompression surgery is successful in relieving symptoms of lumbar spinal stenosis. Physical function, back and leg pain are significantly improved after 5 years but initial significant improvements in social function diminish over time.

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“…Another study [17] showed poor results in the diabetic patients that may have been related to coexisting diabetic neuropathy. A recently published study by Airaksinen et al [1] concluded that diabetes was associated with poor surgical outcome.…”

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confidence: 99%

Outcomes of decompression surgery for lumbar spinal stenosis in elderly diabetic patients

Arinzon¹,

Adunsky

Fidelman³

et al. 2004

European Spine Journal

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Surgical Outcome of 438 Patients Treated Surgically for Lumbar Spinal Stenosis

Abstract: The results suggest that clear myelographic stenosis and no prior surgical intervention, no comorbidity of diabetes, no hip joint arthrosis, and no preoperative fracture of the lumbar spine are factors associated with a good outcome in surgical management of lumbar spinal stenosis.

Cited by 235 publications

References 17 publications

Which patient-reported factors predict referral to spinal surgery? A cohort study among 4987 chronic low back pain patients

Which patient-reported factors predict referral to spinal surgery? A cohort study among 4987 chronic low back pain patients

The outcome of spinal decompression surgery 5 years on

Outcomes of decompression surgery for lumbar spinal stenosis in elderly diabetic patients

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