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The Influence of Preoperative Back Pain on the Outcome of Lumbar Decompression Surgery
Prospective study with 12-month follow-up. To examine how the relative severity of low back pain (LBP) to leg/buttock pain (LP) influences the outcome of decompression surgery for spinal stenosis. Decompression surgery is a common treatment for lumbar spinal canal stenosis, with generally good outco...
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| Published in: | Spine (Philadelphia, PA. 1976) PA. 1976), 2009-05, Vol.34 (11), p.1198-1203 |
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| container_title | Spine (Philadelphia, PA. 1976) |
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| creator | KLEINSTÜCK, Frank S GROB, Dieter LATTIG, Friederike BARTANUSZ, Viktor PORCHET, Francois JESZENSZKY, Oezsö O'RIORDAN, David MANNION, Anne F |
| description | Prospective study with 12-month follow-up.
To examine how the relative severity of low back pain (LBP) to leg/buttock pain (LP) influences the outcome of decompression surgery for spinal stenosis.
Decompression surgery is a common treatment for lumbar spinal canal stenosis, with generally good outcome. However, concomitant LBP at presentation can make it difficult to decide whether decompression alone will result in a good overall outcome.
The Spine Society of Europe Spine Tango system was used to acquire the data from 221 patients. Inclusion criteria were lumbar degenerative spinal stenosis, first-time surgery, maximum 3 affected levels, and decompression as the only procedure. Before and 12 months after surgery, patients completed the multidimensional Core Outcome Measures Index (COMI; includes 0-10 LP and LBP scales); at 12 months, global outcome was rated on a Likert-scale and dichotomized into "good" and "poor" groups.
There was a low but significant positive correlation between baseline LP-minus-LBP scores and both improvement in the multidimensional COMI score after 12 months (r = 0.21, P = 0.003) and the score on the 12-month global outcome scale (r = 0.19, P = 0.007). In the good outcome group, mean baseline LP was 2.3 (+/-3.7) points higher than LBP; in the poor group, the corresponding value was 0.8 (+/-3.4) (P = 0.01 between groups). In multivariate regression analyses (controlling for age, gender, comorbidity), baseline LBP intensity was the most significant predictor of the 12-month COMI score, and preoperative LP-minus-LBP score of the global outcome (each P < 0.05).
Overall, greater back pain relative to LP at baseline was associated with a significantly worse outcome after decompression. This finding seems intuitive, but has rarely been quantified in the many predictor studies conducted to date. Consideration of relative LBP and LP scores may assist in clinical decision-making and in establishing realistic patient expectations. |
| doi_str_mv | 10.1097/brs.0b013e31819fcf35 |
| format | article |
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To examine how the relative severity of low back pain (LBP) to leg/buttock pain (LP) influences the outcome of decompression surgery for spinal stenosis.
Decompression surgery is a common treatment for lumbar spinal canal stenosis, with generally good outcome. However, concomitant LBP at presentation can make it difficult to decide whether decompression alone will result in a good overall outcome.
The Spine Society of Europe Spine Tango system was used to acquire the data from 221 patients. Inclusion criteria were lumbar degenerative spinal stenosis, first-time surgery, maximum 3 affected levels, and decompression as the only procedure. Before and 12 months after surgery, patients completed the multidimensional Core Outcome Measures Index (COMI; includes 0-10 LP and LBP scales); at 12 months, global outcome was rated on a Likert-scale and dichotomized into "good" and "poor" groups.
There was a low but significant positive correlation between baseline LP-minus-LBP scores and both improvement in the multidimensional COMI score after 12 months (r = 0.21, P = 0.003) and the score on the 12-month global outcome scale (r = 0.19, P = 0.007). In the good outcome group, mean baseline LP was 2.3 (+/-3.7) points higher than LBP; in the poor group, the corresponding value was 0.8 (+/-3.4) (P = 0.01 between groups). In multivariate regression analyses (controlling for age, gender, comorbidity), baseline LBP intensity was the most significant predictor of the 12-month COMI score, and preoperative LP-minus-LBP score of the global outcome (each P < 0.05).
Overall, greater back pain relative to LP at baseline was associated with a significantly worse outcome after decompression. This finding seems intuitive, but has rarely been quantified in the many predictor studies conducted to date. Consideration of relative LBP and LP scores may assist in clinical decision-making and in establishing realistic patient expectations.</description><identifier>ISSN: 0362-2436</identifier><identifier>EISSN: 1528-1159</identifier><identifier>DOI: 10.1097/brs.0b013e31819fcf35</identifier><identifier>PMID: 19407677</identifier><identifier>CODEN: SPINDD</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Aged ; Aged, 80 and over ; Back Pain - physiopathology ; Biological and medical sciences ; Cerebrospinal fluid. Meninges. Spinal cord ; Decompression, Surgical - methods ; Diseases of the osteoarticular system ; Diseases of the spine ; Female ; Humans ; Lumbar Vertebrae ; Male ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Nervous system (semeiology, syndromes) ; Neurology ; Outcome Assessment (Health Care) ; Prospective Studies ; Regression Analysis ; Spinal Stenosis - surgery ; Time Factors</subject><ispartof>Spine (Philadelphia, PA. 1976), 2009-05, Vol.34 (11), p.1198-1203</ispartof><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c430t-df9d3e0ada1ca619f0c39183effea2e1b9ba6f992eff7e7ec94705084b2696ba3</citedby><cites>FETCH-LOGICAL-c430t-df9d3e0ada1ca619f0c39183effea2e1b9ba6f992eff7e7ec94705084b2696ba3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>310,311,315,786,790,795,796,23958,23959,25170,27957,27958</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21534457$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19407677$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>KLEINSTÜCK, Frank S</creatorcontrib><creatorcontrib>GROB, Dieter</creatorcontrib><creatorcontrib>LATTIG, Friederike</creatorcontrib><creatorcontrib>BARTANUSZ, Viktor</creatorcontrib><creatorcontrib>PORCHET, Francois</creatorcontrib><creatorcontrib>JESZENSZKY, Oezsö</creatorcontrib><creatorcontrib>O'RIORDAN, David</creatorcontrib><creatorcontrib>MANNION, Anne F</creatorcontrib><title>The Influence of Preoperative Back Pain on the Outcome of Lumbar Decompression Surgery</title><title>Spine (Philadelphia, PA. 1976)</title><addtitle>Spine (Phila Pa 1976)</addtitle><description>Prospective study with 12-month follow-up.
To examine how the relative severity of low back pain (LBP) to leg/buttock pain (LP) influences the outcome of decompression surgery for spinal stenosis.
Decompression surgery is a common treatment for lumbar spinal canal stenosis, with generally good outcome. However, concomitant LBP at presentation can make it difficult to decide whether decompression alone will result in a good overall outcome.
The Spine Society of Europe Spine Tango system was used to acquire the data from 221 patients. Inclusion criteria were lumbar degenerative spinal stenosis, first-time surgery, maximum 3 affected levels, and decompression as the only procedure. Before and 12 months after surgery, patients completed the multidimensional Core Outcome Measures Index (COMI; includes 0-10 LP and LBP scales); at 12 months, global outcome was rated on a Likert-scale and dichotomized into "good" and "poor" groups.
There was a low but significant positive correlation between baseline LP-minus-LBP scores and both improvement in the multidimensional COMI score after 12 months (r = 0.21, P = 0.003) and the score on the 12-month global outcome scale (r = 0.19, P = 0.007). In the good outcome group, mean baseline LP was 2.3 (+/-3.7) points higher than LBP; in the poor group, the corresponding value was 0.8 (+/-3.4) (P = 0.01 between groups). In multivariate regression analyses (controlling for age, gender, comorbidity), baseline LBP intensity was the most significant predictor of the 12-month COMI score, and preoperative LP-minus-LBP score of the global outcome (each P < 0.05).
Overall, greater back pain relative to LP at baseline was associated with a significantly worse outcome after decompression. This finding seems intuitive, but has rarely been quantified in the many predictor studies conducted to date. Consideration of relative LBP and LP scores may assist in clinical decision-making and in establishing realistic patient expectations.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Back Pain - physiopathology</subject><subject>Biological and medical sciences</subject><subject>Cerebrospinal fluid. Meninges. Spinal cord</subject><subject>Decompression, Surgical - methods</subject><subject>Diseases of the osteoarticular system</subject><subject>Diseases of the spine</subject><subject>Female</subject><subject>Humans</subject><subject>Lumbar Vertebrae</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Outcome Assessment (Health Care)</subject><subject>Prospective Studies</subject><subject>Regression Analysis</subject><subject>Spinal Stenosis - surgery</subject><subject>Time Factors</subject><issn>0362-2436</issn><issn>1528-1159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><recordid>eNpd0NtKw0AQBuBFFFsPbyCSG71L3VN2s5e2ngqFFlu9DZvNrEZzcjcR-vZGGxS8Ghi-f2B-hM4InhCs5FXq_ASnmDBgJCbKGsuiPTQmEY1DQiK1j8aYCRpSzsQIHXn_hjEWjKhDNCKKYymkHKPnzSsE88oWHVQGgtoGKwd1A063-ScEU23eg5XOq6Cugrany641dfkDF12ZahfcQL9oHHif92bduRdw2xN0YHXh4XSYx-jp7nYzewgXy_v57HoRGs5wG2ZWZQywzjQxWvRPYMMUiRlYC5oCSVWqhVWK9gsJEoziEkc45ikVSqSaHaPL3d3G1R8d-DYpc2-gKHQFdecTISlXPI56yHfQuNp7BzZpXF5qt00ITr77TKaP6-R_n33sfLjfpSVkf6GhwB5cDEB7owvrdGVy_-soiRjnkWRfGTCApQ</recordid><startdate>20090515</startdate><enddate>20090515</enddate><creator>KLEINSTÜCK, Frank S</creator><creator>GROB, Dieter</creator><creator>LATTIG, Friederike</creator><creator>BARTANUSZ, Viktor</creator><creator>PORCHET, Francois</creator><creator>JESZENSZKY, Oezsö</creator><creator>O'RIORDAN, David</creator><creator>MANNION, Anne F</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20090515</creationdate><title>The Influence of Preoperative Back Pain on the Outcome of Lumbar Decompression Surgery</title><author>KLEINSTÜCK, Frank S ; GROB, Dieter ; LATTIG, Friederike ; BARTANUSZ, Viktor ; PORCHET, Francois ; JESZENSZKY, Oezsö ; O'RIORDAN, David ; MANNION, Anne F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c430t-df9d3e0ada1ca619f0c39183effea2e1b9ba6f992eff7e7ec94705084b2696ba3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Back Pain - physiopathology</topic><topic>Biological and medical sciences</topic><topic>Cerebrospinal fluid. Meninges. Spinal cord</topic><topic>Decompression, Surgical - methods</topic><topic>Diseases of the osteoarticular system</topic><topic>Diseases of the spine</topic><topic>Female</topic><topic>Humans</topic><topic>Lumbar Vertebrae</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Outcome Assessment (Health Care)</topic><topic>Prospective Studies</topic><topic>Regression Analysis</topic><topic>Spinal Stenosis - surgery</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>KLEINSTÜCK, Frank S</creatorcontrib><creatorcontrib>GROB, Dieter</creatorcontrib><creatorcontrib>LATTIG, Friederike</creatorcontrib><creatorcontrib>BARTANUSZ, Viktor</creatorcontrib><creatorcontrib>PORCHET, Francois</creatorcontrib><creatorcontrib>JESZENSZKY, Oezsö</creatorcontrib><creatorcontrib>O'RIORDAN, David</creatorcontrib><creatorcontrib>MANNION, Anne F</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Spine (Philadelphia, PA. 1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>KLEINSTÜCK, Frank S</au><au>GROB, Dieter</au><au>LATTIG, Friederike</au><au>BARTANUSZ, Viktor</au><au>PORCHET, Francois</au><au>JESZENSZKY, Oezsö</au><au>O'RIORDAN, David</au><au>MANNION, Anne F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Influence of Preoperative Back Pain on the Outcome of Lumbar Decompression Surgery</atitle><jtitle>Spine (Philadelphia, PA. 1976)</jtitle><addtitle>Spine (Phila Pa 1976)</addtitle><date>2009-05-15</date><risdate>2009</risdate><volume>34</volume><issue>11</issue><spage>1198</spage><epage>1203</epage><pages>1198-1203</pages><issn>0362-2436</issn><eissn>1528-1159</eissn><coden>SPINDD</coden><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Prospective study with 12-month follow-up.
To examine how the relative severity of low back pain (LBP) to leg/buttock pain (LP) influences the outcome of decompression surgery for spinal stenosis.
Decompression surgery is a common treatment for lumbar spinal canal stenosis, with generally good outcome. However, concomitant LBP at presentation can make it difficult to decide whether decompression alone will result in a good overall outcome.
The Spine Society of Europe Spine Tango system was used to acquire the data from 221 patients. Inclusion criteria were lumbar degenerative spinal stenosis, first-time surgery, maximum 3 affected levels, and decompression as the only procedure. Before and 12 months after surgery, patients completed the multidimensional Core Outcome Measures Index (COMI; includes 0-10 LP and LBP scales); at 12 months, global outcome was rated on a Likert-scale and dichotomized into "good" and "poor" groups.
There was a low but significant positive correlation between baseline LP-minus-LBP scores and both improvement in the multidimensional COMI score after 12 months (r = 0.21, P = 0.003) and the score on the 12-month global outcome scale (r = 0.19, P = 0.007). In the good outcome group, mean baseline LP was 2.3 (+/-3.7) points higher than LBP; in the poor group, the corresponding value was 0.8 (+/-3.4) (P = 0.01 between groups). In multivariate regression analyses (controlling for age, gender, comorbidity), baseline LBP intensity was the most significant predictor of the 12-month COMI score, and preoperative LP-minus-LBP score of the global outcome (each P < 0.05).
Overall, greater back pain relative to LP at baseline was associated with a significantly worse outcome after decompression. This finding seems intuitive, but has rarely been quantified in the many predictor studies conducted to date. Consideration of relative LBP and LP scores may assist in clinical decision-making and in establishing realistic patient expectations.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>19407677</pmid><doi>10.1097/brs.0b013e31819fcf35</doi><tpages>6</tpages></addata></record> |
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| ispartof | Spine (Philadelphia, PA. 1976), 2009-05, Vol.34 (11), p.1198-1203 |
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| subjects | Aged Aged, 80 and over Back Pain - physiopathology Biological and medical sciences Cerebrospinal fluid. Meninges. Spinal cord Decompression, Surgical - methods Diseases of the osteoarticular system Diseases of the spine Female Humans Lumbar Vertebrae Male Medical sciences Middle Aged Multivariate Analysis Nervous system (semeiology, syndromes) Neurology Outcome Assessment (Health Care) Prospective Studies Regression Analysis Spinal Stenosis - surgery Time Factors |
| title | The Influence of Preoperative Back Pain on the Outcome of Lumbar Decompression Surgery |
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