Clinical Outcomes for Neurogenic Claudication Using a Multimodal Program for Lumbar Spinal Stenosis: A Retrospective Study

Background: Our hypothesis was that by identifying certain preoperative predictive factors, we could favorably impact clinical outcomes in patients undergoing decompressive surgery for lumbar spinal stenosis (LSS). Methods: In this retrospective study, there were 65 patients (2016–2018) with symptomatic LSS who underwent decompressive laminectomy without fusion. Their clinical outcomes were assessed utilizing the Oswestry Disability Index (ODI). Multiple preoperative variables were studied to determine which ones would help predict improved outcomes: gender, age, body mass index (BMI), general/neurological examination, smoking, and drug therapies (anxiolytics and/or antidepressants). Results: All patients demonstrated statistically significant improvement on the ODI. Multivariate analysis revealed that those with higher preoperative BMI had significantly lower ODI on 1-year follow-up examinations, reflecting poorer outcomes. Postoperatively, 44 patients (67%) exhibited lower utilization of anxiolytic medications, 52 patients (80%) showed reduced use of antidepressant drugs, and pain medications utilization was reduced in 33 patients (50%). Conclusion: Decompressive laminectomy without fusion effectively managed LSS. It reduced patients’ use of pain, anxiety, and antidepressant medications. In addition, we found that increased preoperative BMIs contributed to poorer postoperative outcomes (e.g., ODI values).

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Stuburo juosmeninės dalies kanalo stenozė: klinikinė anatomija, diagnostika (I dalis)

Lietuvos chirurgija ◽

10.15388/lietchirur.2003.4.2395 ◽

2003 ◽

Vol 1 (4) ◽

pp. 0-0

Author(s):

Valentinas Uvarovas ◽

Giedrius Kvederas ◽

Igoris Šatkauskas

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Nerve Root ◽

Cauda Equina ◽

Neurogenic Claudication ◽

Clinical Anatomy ◽

Ageing Population ◽

Imaging Studies ◽

Pathologic Features ◽

Lumbar Spinal

Valentinas Uvarovas, Giedrius Kvederas, Igoris ŠatkauskasVilniaus universiteto Ortopedijos, traumatologijos ir plastinės chirurgijos klinikaVilniaus greitosios pagalbos universitetinė ligoninėŠiltnamių g. 29, LT-2043 VilniusEl paštas: [email protected] Pasaulyje ženkliai auga pagyvenusių žmonių populiacija, kartu daugėja ligų, kuriomis dažniausiai sergama perkopus į antrą gyvenimo pusę. Viena iš tokių ligų yra stuburo kanalo stenozė, t. y. susiaurėjimas. Dažniausia stuburo kanalo stenozės priežastis yra su amžiumi progresuojantys stuburo degeneraciniai pokyčiai. Ne visada arklio uodegos ar nervų šaknelių spaudimas sukelia dirginimo simptomus, tačiau progresuojant patologiniams anatominiams ir fiziologiniams pokyčiams gali išryškėti klinika. Kartais rentgenologiniai duomenys neatspindi klinikos, todėl labai svarbu tiksliai įvertinti ligos simptomus, jų eigą bei rentgenologinius duomenis, kad būtų pasirinkta tinkama gydymo taktika. Prasminai žodžiai: stuburo kanalo stenozė, neurogeninė klaudikacija, nervinės šaknelės, arklio uodega Lumbar spinal stenosis: clinical anatomy, diagnostics Valentinas Uvarovas, Giedrius Kvederas, Igoris Šatkauskas Lumbar spinal stenosis remains one of the most frequently encountered clinical important degenerative spinal disorders in the ageing population. Spinal stenosis is a narrowing or stricture of the spinal canal. Cauda equina and nerve root compression are noted in many asymptomatic individuals. The spinal degenerative process associated with ageing leads to pathoanatomical and pathophysiological changes with occasional clinical consequences. With progressive degenerative changes and compression, spinal stenosis may become symptomatic, although the severity of the symptoms is not necessarily associated with the magnitude of the compression seen on imaging studies. A thorough understanding of the etiology, pathologic features and a correlation between the symptoms and the precise location of the thecal sac and nerve root are very important in evaluating the imaging studies and planning appropriate treatment. Keywords: lumbar spinal stenosis, neurogenic claudication, spinal nerve root, cauda equina

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Outcome of Surgical Treatment of Degenerative Lumbar Spinal Stenosis.

Medical Journal of Shree Birendra Hospital ◽

10.3126/mjsbh.v14i1.14838 ◽

2016 ◽

Vol 14 (1) ◽

pp. 25-28

Author(s):

Bishnu Babu Thapa ◽

Sushil Rana Magar ◽

Pankaj Chand ◽

Bachhu Ram KC

Keyword(s):

Conservative Treatment ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Leg Pain ◽

Walking Distance ◽

Neurogenic Claudication ◽

Long Term Outcome ◽

Degenerative Lumbar Spinal Stenosis ◽

Vas Score ◽

Lumbar Spinal

Introduction: Spinal stenosis mostly occur in lumbar spine and causes back pain, leg pain & neurogenic claudication. Although conservative treatment is mainstay, decompression with or without fusion (with or without instrumentation) can be considered in non-responsive cases. However, long term outcome of the surgery is controversial. The aim of our study was to analyze the outcome of surgery in lumbar spinal stenosis in terms of post-operative pain and claudication distance.Methods: A prospective analysis of patients who underwent decompression or decompression with fusion (with or without instrumentation), after failure of 3-6 months conservative treatment, for lumbar spinal stenosis were conducted. Only those who were operated and followed up for at least two years were included.Their preop and postop VAS score and walking distance compared.Results: Of 22 cases enrolled in this study, VAS score was improved in 21 patients and walking distance increased. Only one patient complained of increase in pain score at 24 months.Conclusion: Operative management is a good option for selected patients, 21 out of 22 have improved VAS and claudication distance in our study

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Indications for fusion following decompression for lumbar spinal stenosis

Neurosurgical FOCUS ◽

10.3171/foc.1997.3.2.5 ◽

1997 ◽

Vol 3 (2) ◽

pp. E4 ◽

Cited By ~ 8

Author(s):

Mark W. Fox ◽

Burton M. Onofrio

Keyword(s):

Clinical Outcomes ◽

Elderly People ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Decompressive Surgery ◽

Common Condition ◽

Decompressive Laminectomy ◽

Degenerative Lumbar Spinal Stenosis ◽

Lumbar Spinal ◽

Better Than

Degenerative lumbar spinal stenosis is a common condition affecting middle-aged and elderly people. Significant controversy exists concerning the appropriate indications for fusion following decompressive surgery. The purpose of this report is to compare the clinical outcomes of patients who were and were not treated with fusion following decompressive laminectomy for spinal stenosis and to identify whether fusion was beneficial. The authors conclude that patients in whom concomitant fusion procedures were performed fared better than patients who were treated by means of decompression alone when evidence of radiological instability existed preoperatively.

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