Prognostic factors in lumbar spinal stenosis surgery. A prospective study of imaging- and patient-related factors in 109 patients who were operated on by decompression
(2012) In Acta Orthopaedica 83(5). p.536-542- Abstract
- Background and purpose A considerable number of patients who undergo surgery for spinal stenosis have residual symptoms and inferior function and health-related quality of life after surgery. There have been few studies on factors that may predict outcome. We tried to find predictors of outcome in surgery for spinal stenosis using patient- and imaging-related factors. Patients and methods 109 patients in the Swedish Spine Register with central spinal stenosis that were operated on by decompression without fusion were prospectively followed up 1 year after surgery. Clinical outcome scores included the EQ-5D, the Oswestry disability index, self-estimated walking distance, and leg and back pain levels (VAS). Central dural sac area, number of... (More)
- Background and purpose A considerable number of patients who undergo surgery for spinal stenosis have residual symptoms and inferior function and health-related quality of life after surgery. There have been few studies on factors that may predict outcome. We tried to find predictors of outcome in surgery for spinal stenosis using patient- and imaging-related factors. Patients and methods 109 patients in the Swedish Spine Register with central spinal stenosis that were operated on by decompression without fusion were prospectively followed up 1 year after surgery. Clinical outcome scores included the EQ-5D, the Oswestry disability index, self-estimated walking distance, and leg and back pain levels (VAS). Central dural sac area, number of levels with stenosis, and spondylolisthesis were included in the MRI analysis. Multivariable analyses were performed to search for correlation between patient-related and imaging factors and clinical outcome at 1-year follow-up. Results Several factors predicted outcome statistically significantly. Duration of leg pain exceeding 2 years predicted inferior outcome in terms of leg and back pain, function, and HRLQoL. Regular and intermittent preoperative users of analgesics had higher levels of back pain at follow-up than those not using analgesics. Low preoperative function predicted low function and dissatisfaction at follow-up. Low preoperative EQ-5D scores predicted a high degree of leg and back pain. Narrow dural sac area predicted more gains in terms of back pain at follow-up and lower absolute leg pain. Interpretation Multiple factors predict outcome in spinal stenosis surgery, most importantly duration of symptoms and preoperative function. Some of these are modifiable and can be targeted. Our findings can be used in the preoperative patient information and aid the surgeon and the patient in a shared decision making process. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/3160544
- author
- Sigmundsson, Freyr Gauti LU ; Kang, Xiao P ; Jönsson, Bo LU and Strömqvist, Björn LU
- organization
- publishing date
- 2012
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Acta Orthopaedica
- volume
- 83
- issue
- 5
- pages
- 536 - 542
- publisher
- Taylor & Francis
- external identifiers
-
- wos:000310015700017
- pmid:23083437
- scopus:84867849979
- pmid:23083437
- ISSN
- 1745-3682
- DOI
- 10.3109/17453674.2012.733915
- language
- English
- LU publication?
- yes
- id
- 5932c7d1-c4db-4e85-98a0-023400b6b5c8 (old id 3160544)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/23083437?dopt=Abstract
- date added to LUP
- 2016-04-01 14:24:15
- date last changed
- 2022-03-29 20:46:16
@article{5932c7d1-c4db-4e85-98a0-023400b6b5c8,
abstract = {{Background and purpose A considerable number of patients who undergo surgery for spinal stenosis have residual symptoms and inferior function and health-related quality of life after surgery. There have been few studies on factors that may predict outcome. We tried to find predictors of outcome in surgery for spinal stenosis using patient- and imaging-related factors. Patients and methods 109 patients in the Swedish Spine Register with central spinal stenosis that were operated on by decompression without fusion were prospectively followed up 1 year after surgery. Clinical outcome scores included the EQ-5D, the Oswestry disability index, self-estimated walking distance, and leg and back pain levels (VAS). Central dural sac area, number of levels with stenosis, and spondylolisthesis were included in the MRI analysis. Multivariable analyses were performed to search for correlation between patient-related and imaging factors and clinical outcome at 1-year follow-up. Results Several factors predicted outcome statistically significantly. Duration of leg pain exceeding 2 years predicted inferior outcome in terms of leg and back pain, function, and HRLQoL. Regular and intermittent preoperative users of analgesics had higher levels of back pain at follow-up than those not using analgesics. Low preoperative function predicted low function and dissatisfaction at follow-up. Low preoperative EQ-5D scores predicted a high degree of leg and back pain. Narrow dural sac area predicted more gains in terms of back pain at follow-up and lower absolute leg pain. Interpretation Multiple factors predict outcome in spinal stenosis surgery, most importantly duration of symptoms and preoperative function. Some of these are modifiable and can be targeted. Our findings can be used in the preoperative patient information and aid the surgeon and the patient in a shared decision making process.}},
author = {{Sigmundsson, Freyr Gauti and Kang, Xiao P and Jönsson, Bo and Strömqvist, Björn}},
issn = {{1745-3682}},
language = {{eng}},
number = {{5}},
pages = {{536--542}},
publisher = {{Taylor & Francis}},
series = {{Acta Orthopaedica}},
title = {{Prognostic factors in lumbar spinal stenosis surgery. A prospective study of imaging- and patient-related factors in 109 patients who were operated on by decompression}},
url = {{https://lup.lub.lu.se/search/files/3957170/3223773.pdf}},
doi = {{10.3109/17453674.2012.733915}},
volume = {{83}},
year = {{2012}},
}