Preoperative Predictors of Better Long-term Functional Ability and Decreased Pain Following LSS Surgery: A Prospective Observational Study with a 10-year Follow-up Period.
Adult
Aged
Aged, 80 and over
Cross-Sectional Studies
Decompression, Surgical
/ trends
Female
Follow-Up Studies
Humans
Laminectomy
/ trends
Lumbar Vertebrae
/ diagnostic imaging
Male
Middle Aged
Pain
/ diagnostic imaging
Pain Measurement
/ trends
Predictive Value of Tests
Preoperative Care
/ trends
Prospective Studies
Spinal Stenosis
/ diagnostic imaging
Surveys and Questionnaires
Time Factors
Journal
Spine
ISSN: 1528-1159
Titre abrégé: Spine (Phila Pa 1976)
Pays: United States
ID NLM: 7610646
Informations de publication
Date de publication:
01 Jun 2020
01 Jun 2020
Historique:
pubmed:
11
1
2020
medline:
30
9
2020
entrez:
11
1
2020
Statut:
ppublish
Résumé
A prospective observational 10-year follow-up study. This study aimed to examine preoperative predictors for better surgical outcomes in patients with lumbar spinal stenosis (LSS) 10 years after surgery. LSS is a leading cause of low back surgery in patients older than 65 years. Limited data are available for predictors of long-term surgical outcomes in patients with LSS. 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 nonsmoking 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. Using multivariate analysis, statistically significant predictors for lower ODI and VAS scores at 10 years were nonsmoking status, absence of previous lumbar surgery, better self-rated health, and regular use of painkillers for <12 months. Patients who smoked preoperatively or had previous lumbar surgery experienced more pain and disability at the 10-year follow-up. These 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 5 years. 3.
Sections du résumé
STUDY DESIGN
METHODS
A prospective observational 10-year follow-up study.
OBJECTIVE
OBJECTIVE
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 DATA
BACKGROUND
LSS is a leading cause of low back surgery in patients older than 65 years. Limited data are available for predictors of long-term surgical outcomes in patients with LSS.
METHODS
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 nonsmoking 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
RESULTS
Using multivariate analysis, statistically significant predictors for lower ODI and VAS scores at 10 years were nonsmoking status, absence of previous lumbar surgery, better self-rated health, and regular use of painkillers for <12 months. Patients who smoked preoperatively or had previous lumbar surgery experienced more pain and disability at the 10-year follow-up.
CONCLUSION
CONCLUSIONS
These 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 5 years.
LEVEL OF EVIDENCE
METHODS
3.
Identifiants
pubmed: 31923129
doi: 10.1097/BRS.0000000000003374
pii: 00007632-202006010-00019
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
776-783Références
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