What comprises a good outcome in spinal surgery? A preliminary survey among spine surgeons of the SSE and European spine patients

Haefeli, Mathias; Aebi, Max; Freeman, Brian J. C.; Fritzell, Peter; Consciência, José Guimarães; Lamartina, Claudio; Mayer, Michael H.; Lund, Teija; Boos, Norbert

doi:10.1007/s00586-007-0541-5

Cited by 37 publications

(20 citation statements)

References 21 publications

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“…Effective scientific evaluation governed by reliable scientific principles is essential. 18,19 Thus, we fully agree with those [20][21][22][23][24][25][26][27] who recommend the use of multiple means of measurement that respect cultural, social, and personal differences present in the patients that we propose to evaluate, and it is in this manner that we developed this prospective study.…”

Section: Discussionsupporting

confidence: 82%

Evolução psicossomática e clínica de pacientes com estenose do canal lombar operados com sistema interespinhoso

Consciência

2013

Coluna/Columna

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Objective: The goal of this study was to evaluate the efficacy of interspinous spacers in degenerative lumbar disease and the evolution of patient's depression status and somatization preexisting symptoms. Methods: 20 patients with degenerative lumbar spinal stenosis were evaluated. Considering the different inclusion criteria, patients agreed to participate in the study by signing the written consent form. For clinical and psychosomatic assessment we used Euroqol Score (EQ-5D) for lumbar spine and lower limbs, Visual Analogue Scale (VAS); Oswestry Disability Index version 2.0 and Modified Somatic Perception Questionnaire (MSPQ); and Zung Self-Rating Depression Scale (ZDS). Statistical analysis was performed using Friedman and Wilcoxon tests, with significance level of 0.05. Results: There was an improvement in EQ-5D (p<0.001), VAS for lumbar spine and lower limbs (p<0.001), ODI (p<0.001), without significant changes in MSPQ (p=0.197). Conclusion: In patients with degenerative lumbar disease (Benzel grade 2, 3 and Pfirmann grade 3, 4) and stable in psychosomatic terms, the use of interspinous spacers proved effective clinical progression and improved the rate of depression related to the pre-existing pathology.Keywords: Spine; Quality of live; Depression; Orthopaedic fixation devices; Lumbar vertebrae/surgery. RESUMO Objetivo: Procuramos avaliar a eficácia terapêutica de estabilizadores interespinosos na doença degenerativa lombar, e a evolução do

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Section: Discussionsupporting

confidence: 82%

Evolução psicossomática e clínica de pacientes com estenose do canal lombar operados com sistema interespinhoso

Consciência

2013

Coluna/Columna

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“…Because their mobility and activities of daily living tend to be affected, the fear of losing their independence is greater than that in younger individuals. 27 This stresses the importance of setting realistic expectations for the patients. Interestingly, a study by Gepstein et al 22 found that in patients older than 64 years, there was such a correlation between high expectations and satisfaction in those treated for lumbar spinal stenosis that preoperative expectations could be used to predict patient satisfaction.…”

Section: Clinical Outcomementioning

confidence: 99%

Complications and outcomes after spinal deformity surgery in the elderly: review of the existing literature and future directions

Drazin

Shirzadi²,

Rosner³

et al. 2011

FOC

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Object The elderly population (age > 60 years) is the fastest-growing age group in the US. Spinal deformity is a major problem affecting the elderly and, therefore, the demand for surgery for spinal deformity is becoming increasingly prevalent in elderly patients. Much of the literature on surgery for adult deformity focuses on patients who are younger than 60 years, and therefore there is limited information about the complications and outcomes of surgery in the elderly population. In this study, the authors undertook a review of the literature on spinal deformity surgery in patients older than 60 years. The authors discuss their analysis with a focus on outcomes, complications, discrepancies between individual studies, and strategies for complication avoidance. Methods A systematic review of the MEDLINE and PubMed databases was performed to identify articles published from 1950 to the present using the following key words: “adult scoliosis surgery” and “adult spine deformity surgery.” Exclusion criteria included patient age younger than 60 years. Data on major Oswestry Disability Index (ODI) scores, visual analog scale (VAS) scores, patient-reported outcomes, and complications were recorded. Results Twenty-two articles were obtained and are included in this review. The mean age was 74.2 years, and the mean follow-up period was 3 years. The mean preoperative ODI was 48.6, and the mean postoperative reduction in ODI was 24.1. The mean preoperative VAS score was 7.7 with a mean postoperative decrease of 5.2. There were 311 reported complications for 815 patients (38%) and 5 deaths for 659 patients (< 1%). Conclusions Elderly patient outcomes were inconsistent in the published studies. Overall, most elderly patients obtained favorable outcomes with low operative mortality following surgery for adult spinal deformity.

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“…Incidence of lumbar spinal stenosis is increasing due to the aging population [25,26]. Lumbar stenosis is detected also more frequently these days, due to the better quality and availability of radiological imaging facilities.…”

Section: Discussionmentioning

confidence: 99%

Correlation of Lateral Stenosis in MRI with Symptoms, Walking Capacity, and EMG Findings in Patients with Surgically Confirmed Lateral Lumbar Spinal Canal Stenosis

Kuittinen

Sipola

Aalto

et al. 2014

Global Spine Journal

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Background: To evaluate the clinical significance of lateral lumbar spinal canal stenosis (LLSCS), found by magnetic resonance imaging (MRI), through correlating the imaging findings with patient symptoms, walking capacity and electromyography (EMG) measurements. Method: 102 patients with symptoms of LSS referred for operative treatment were studied in this uncontrolled study. Of these patients, subjects with distinct only lateral LSS were included. Accordingly, 140 roots in 14 patients (mean age 58, range 48-76 years, male 43%) were evaluated. In MR images the entrance and mid zones of the lateral lumbar nerve root canal were graded as normal, narrowed but not compressed, or compressed. In quantitative analysis, the minimal widths of the lateral recess and mid zone area were measured. Clinical symptoms were recorded with the Oswestry Disability Index (ODI), overall Visual Analogue Scale (VAS), specific low back pain (LBP; NRS-11), specific leg pain (LP NRS-11), Beck Depression Inventory (BDI) and walking distance in the treadmill test. Lumbar paraspinal (L2-L5) and lower limb (L3 -S1) needle EMG studies were performed. The findings were classified root by root as 1 = normal, 2 = abnormal. The associations between radiological, EMG and clinical findings were tested with each other. Results: EMG findings were normal in 92 roots and abnormal in 48 roots. All of the patients had at least one abnormal nerve root finding. Severity of the mid zone stenosis in MRI correlated with abnormal EMG findings (p = 0.015). Patients with abnormal EMG had also higher scores in the VAS (41.9 ± 25.7 vs 31.5 ± 18.1; p = 0.018), NRS leg pain (7.5 ± 1.5 vs 6.3 ± 2.1; p = 0.000) and BDI (9.8 ± 3.8 vs 8.0 ± 3.9; p = 0.014). However, no statistically significant correlations between MRI findings and clinical symptoms or walking capacity were found. Conclusions: Among persons previously selected for surgery, lateral stenosis seen on MRI correlates with EMG, and thus may be a clinically significant finding. Our EMG findings were also associated with patient symptoms. However, no relationships between the MRI findings and symptoms or walking capacity were found, suggesting their multifactorial etiology.

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What comprises a good outcome in spinal surgery? A preliminary survey among spine surgeons of the SSE and European spine patients

Abstract: Standardized and validated self-administered outcome-instruments are broadly used in spinal surgery.

Cited by 37 publications

References 21 publications

Evolução psicossomática e clínica de pacientes com estenose do canal lombar operados com sistema interespinhoso

Evolução psicossomática e clínica de pacientes com estenose do canal lombar operados com sistema interespinhoso

Complications and outcomes after spinal deformity surgery in the elderly: review of the existing literature and future directions

Correlation of Lateral Stenosis in MRI with Symptoms, Walking Capacity, and EMG Findings in Patients with Surgically Confirmed Lateral Lumbar Spinal Canal Stenosis

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