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The Impact of Pain on Function and Health Related Quality of Life in Lumbar Spinal Stenosis: A Register Study of 14.821 patients.

Sigmundsson, Freyr Gauti LU ; Jönsson, Bo LU and Strömqvist, Björn LU (2013) In Spine
Abstract
Study Design. Descriptive register studyObjective. To describe preoperative levels of leg and back pain in patients operated for lumbar spinal stenosis and to obtain information on how three different pain constellations (back pain < leg leg pain, back pain > leg pain, back pain = leg pain) correlate to HRQoL and function in different morphological types of stenosis.Summary of Background Data. Degenerative lumbar spinal stenosis is considered to be a poorly defined clinical syndrome and knowledge of what uniquely characterizes the different morphological types of stenosis is lacking.Methods. Using the Swedish Spine Register we studied 1) the pain characteristics of patients with central spinal stenosis (CSS), lateral recess stenosis... (More)
Study Design. Descriptive register studyObjective. To describe preoperative levels of leg and back pain in patients operated for lumbar spinal stenosis and to obtain information on how three different pain constellations (back pain < leg leg pain, back pain > leg pain, back pain = leg pain) correlate to HRQoL and function in different morphological types of stenosis.Summary of Background Data. Degenerative lumbar spinal stenosis is considered to be a poorly defined clinical syndrome and knowledge of what uniquely characterizes the different morphological types of stenosis is lacking.Methods. Using the Swedish Spine Register we studied 1) the pain characteristics of patients with central spinal stenosis (CSS), lateral recess stenosis (LRS) and spinal stenosis with spondylolisthesis (SSS) 2) how HRQoL and function correlate to leg and back pain.Results. Grading higher leg than back pain was the most common pain constellation (49%) followed by grading more back than leg pain (39%). 12% had the same intensity of leg and back pain. The type of stenosis grading the highest burden of back pain was SSS (ratio = 0.93; [95%CI] = 0.92-0.95), followed by CSS (ratio = 0.88; [95%CI] = 0.88- 0.89). LRS had the lowest burden of back pain (ratio = 0.85; [95%CI] = 0.83-0.87). The lowest HRQoL and function was found in SSS (back pain = leg pain group) were 55% ([95%CI] = 50-59) of patients could not walk more than 100m. Patients with lateral recess stenosis had better self-estimated walking distance.Conclusion. Back pain is generally experienced to a high extent by patients scheduled for spinal stenosis surgery. HRQoL and function are low preoperatively irrespective of whether back or leg pain is predominant. In this large patient material patients who grade back and leg pain as likeworthy have significantly lower values for HRQoL and function but the difference is not clinically relevant. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Spine
publisher
Lippincott Williams & Wilkins
external identifiers
  • PMID:23591654
  • WOS:000330358500005
  • Scopus:84879931890
ISSN
0362-2436
DOI
10.1097/BRS.0b013e3182955989
language
English
LU publication?
yes
id
821b71c8-4dd1-45f2-a7d6-c51d9ae3f2ac (old id 3733709)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23591654?dopt=Abstract
date added to LUP
2013-05-04 18:57:40
date last changed
2016-10-13 04:27:00
@misc{821b71c8-4dd1-45f2-a7d6-c51d9ae3f2ac,
  abstract     = {Study Design. Descriptive register studyObjective. To describe preoperative levels of leg and back pain in patients operated for lumbar spinal stenosis and to obtain information on how three different pain constellations (back pain &lt; leg leg pain, back pain &gt; leg pain, back pain = leg pain) correlate to HRQoL and function in different morphological types of stenosis.Summary of Background Data. Degenerative lumbar spinal stenosis is considered to be a poorly defined clinical syndrome and knowledge of what uniquely characterizes the different morphological types of stenosis is lacking.Methods. Using the Swedish Spine Register we studied 1) the pain characteristics of patients with central spinal stenosis (CSS), lateral recess stenosis (LRS) and spinal stenosis with spondylolisthesis (SSS) 2) how HRQoL and function correlate to leg and back pain.Results. Grading higher leg than back pain was the most common pain constellation (49%) followed by grading more back than leg pain (39%). 12% had the same intensity of leg and back pain. The type of stenosis grading the highest burden of back pain was SSS (ratio = 0.93; [95%CI] = 0.92-0.95), followed by CSS (ratio = 0.88; [95%CI] = 0.88- 0.89). LRS had the lowest burden of back pain (ratio = 0.85; [95%CI] = 0.83-0.87). The lowest HRQoL and function was found in SSS (back pain = leg pain group) were 55% ([95%CI] = 50-59) of patients could not walk more than 100m. Patients with lateral recess stenosis had better self-estimated walking distance.Conclusion. Back pain is generally experienced to a high extent by patients scheduled for spinal stenosis surgery. HRQoL and function are low preoperatively irrespective of whether back or leg pain is predominant. In this large patient material patients who grade back and leg pain as likeworthy have significantly lower values for HRQoL and function but the difference is not clinically relevant.},
  author       = {Sigmundsson, Freyr Gauti and Jönsson, Bo and Strömqvist, Björn},
  issn         = {0362-2436},
  language     = {eng},
  month        = {04},
  publisher    = {ARRAY(0xc2f9ce0)},
  series       = {Spine},
  title        = {The Impact of Pain on Function and Health Related Quality of Life in Lumbar Spinal Stenosis: A Register Study of 14.821 patients.},
  url          = {http://dx.doi.org/10.1097/BRS.0b013e3182955989},
  year         = {2013},
}