Effectiveness of an exercise-based prehabilitation program for patients awaiting surgery for lumbar spinal stenosis: a randomized clinical trial

AbstractLumbar spinal stenosis is the most common reason for spine surgery in older adults, but the effects of prehabilitation on perioperative outcomes among these patients have not been investigated. This study aims to evaluate the effectiveness of a preoperative exercise-based intervention program compared with usual care on the improvement of clinical status, physical capacities and postoperative recovery of patients awaiting surgery for lumbar spinal stenosis. Sixty-eight participants were randomised to receive either a 6-week supervised exercise-based prehabilitation program or hospital usual care. The outcomes included both clinical and physical measures. Data collection occurred at post-intervention, and 6 weeks, 3- and 6-months post-surgery. Significant but small improvements were found in favour of the experimental group at the post-intervention assessment for pain intensity, lumbar spinal stenosis-related disability, lumbar strength in flexion, low back extensor muscles endurance, total ambulation time, and sit to stand performance. A significant difference in favor of the intervention group was found starting at the 3-month postoperative follow-up for low back-related disability. No adverse events were reported. Exercise-based prehabilitation did not improve short-term postoperative recovery in patients with lumbar spinal stenosis.

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Effect of self-quarantine due to COVID-19 on low back and leg symptoms in patients with lumbar spinal stenosis

10.21203/rs.3.rs-385136/v1 ◽

2021 ◽

Author(s):

Kazunori Hayashi ◽

Toru Tanaka ◽

Tsuneyuki Ebara ◽

Akira Sakawa ◽

Hidekazu Tanaka ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Short Form ◽

Low Back ◽

Significant Difference ◽

Lumbar Spinal ◽

Pain Improvement

Abstract The effect of self-quarantine and avoiding non-essential outings due to COVID-19 on the symptoms of patients with lumbar spinal stenosis (LSS) remains unknown. In this prospective study, patients with LSS who self-quarantined from baseline (SQ group; 80 patients) were matched to controls who did not self-quarantine (non-SQ group: 60 patients), based on age, gender, medication, activities of daily living (ADL), and low back symptoms. The change in low back symptoms, ADL, and health-related quality of life (HRQoL) between baseline and follow-up (after self-quarantine periods) were compared between the groups. Compared to baseline, the NRS score for low back pain at follow-up in SQ group significantly improved, but not in non-SQ group. No significant difference was found regarding changes in leg pain or numbness. Low back pain improvement did not lead to ADL improvement. The Short Form 12 evaluation revealed the role/social component score in SQ group to be lower than that in non-SQ group at follow-up; no difference was found for the physical or mental components. This study revealed self-quarantine with conservative treatment accompanied short-term low back pain improvement in patients with LSS. It might help to understand the situation in the spine department during the COVID-19 pandemic.

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Histopathological Analysis of Ligamentum Flavum in Lumbar Spinal Stenosis and Disc Herniation

Asian Spine Journal ◽

10.4184/asj.2017.11.1.71 ◽

2017 ◽

Vol 11 (1) ◽

pp. 71-74 ◽

Cited By ~ 4

Author(s):

Idiris Altun ◽

Kasım Zafer Yüksel

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Disc Herniation ◽

Ligamentum Flavum ◽

Elastic Fiber ◽

Leg Pain ◽

Histopathological Analysis ◽

Significant Difference ◽

Fiber Number ◽

Lumbar Spinal

<sec><title>Study Design</title>Histopathological analyses were performed in ligamentum flavum (LF) hypertrophy patients with lumbar spinal stenosis (LSS) and lumbar disc herniation (LDH).</sec><sec><title>Purpose</title>The aim of the present study was to evaluate histopathological changes in LF patients with LSS and LDH.</sec><sec><title>Overview of Literature</title>LSS is the most common spinal disorder in elderly patients. This condition causes lower back and leg pain and paresis, and occurs as a result of degenerative changes in the lumbar spine, including bulging of the intervertebral discs, bony proliferation of the facet joints, and LF thickening; among these, LF thickening is considered a major contributor to the development of LSS.</sec><sec><title>Methods</title>A total of 71 patients operated with the surgical indications of LSS and LDH were included. LF samples were obtained from 31 patients who underwent decompressive laminectomy for symptomatic degenerative LSS (stenotic group) and from 40 patients who underwent lumbar discectomy for LDH (discectomy group). LF materials were examined histopathologically, and other specimens were examined for collagen content, elastic fiber number and array, and presence of calcification.</sec><sec><title>Results</title>The stenotic and discectomy groups did not differ with regard to mean collagen concentration or mean elastic fiber number (p=0.430 and p=0.457, respectively). Mean elastic fiber alignment was 2.36±0.99 in the stenotic group and 1.38±0.54 in the discectomy group (<italic>p</italic><0.001). Mean calcification was 0.39±0.50 in the stenotic group, whereas calcification was not detected (0.00±0.00) in the discectomy group; a statistically significant difference was detected (<italic>p</italic><0.001) between groups.</sec><sec><title>Conclusions</title>LF hypertrophy in spinal stenosis may occur as a result of elastic fiber misalignment along with the development of calcification over time. Further studies determining the pathogenesis of LSS are needed.</sec>

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Efficacy and safety of percutaneous transforaminal endoscopic discectomy in the treatment of lumbar spinal stenosis combined with osteoporosis

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.65.6.779 ◽

2019 ◽

Vol 65 (6) ◽

pp. 779-785

Author(s):

Xiaobin Gu ◽

Wenhui Zhu ◽

Haiyi He ◽

Zili Wang ◽

Shaolong Ding ◽

...

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Adverse Reactions ◽

Leg Pain ◽

Control Group ◽

Efficacy And Safety ◽

Significant Difference ◽

Endoscopic Discectomy ◽

Percutaneous Transforaminal Endoscopic Discectomy ◽

Lumbar Spinal

SUMMARY OBJECTIVE: To investigate the efficacy and safety of percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of lumbar spinal stenosis (LSS) combined with osteoporosis. METHODS: Eighty patients with LSS combined with osteoporosis were divided into a control and PTED group, which received conventional transforaminal lumbar interbody fusion and PTED, respectively. The surgical indications, incision visual analogue scale (VAS), lumbar and leg pain VAS, lumbar Japanese Orthopaedic Association (JOA) and Oswestry disability index (ODI) scores, bone mineral density (BMD), and adverse reactions were observed. RESULTS: Compared with the control group, in the PTED group, the operation time, bleeding loss and hospitalization duration, incision VAS scores at postoperative 12, 24 and 48 h and lumbar and leg pain VAS and lumbar ODI scores on postoperative 6 months were significantly decreased (P < 0.01), and the lumbar JOA score on postoperative 6 months was significantly increased (P < 0.05). There was no significant difference in BMD between two groups (P > 0.05). Compared with the control group, in the PTED group, the total effective rate was significantly higher (P < 0.05), and the incidence of adverse reactions was significantly lower (P < 0.05). CONCLUSIONS: PTED is safe and effective in the treatment of LSS combined with osteoporosis.

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Outcomes after decompression surgery without fusion for patients with lumbar spinal stenosis and substantial low back pain

European Spine Journal ◽

10.1007/s00586-019-06130-x ◽

2019 ◽

Vol 29 (1) ◽

pp. 147-152 ◽

Cited By ~ 3

Author(s):

Soichiro Masuda ◽

Yusuke Kanba ◽

Jun Kawai ◽

Noboru Ikeda

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Decompression Surgery ◽

Low Back ◽

Lumbar Spinal

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Low sense of coherence during postoperative recovery is associated with a poorer lumbar spinal stenosis – surgical outcome: A 5-year follow-up study

Journal of Health Psychology ◽

10.1177/1359105315603471 ◽

2016 ◽

Vol 22 (3) ◽

pp. 347-355 ◽

Cited By ~ 3

Author(s):

Maarit Pakarinen ◽

Sanna Sinikallio ◽

Heli Koivumaa-Honkanen ◽

Timo Aalto ◽

Olavi Airaksinen ◽

...

Keyword(s):

Depressive Symptoms ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Sense Of Coherence ◽

Functional Ability ◽

Postoperative Outcome ◽

Postoperative Recovery ◽

Pain Ratings ◽

Lumbar Spinal

This study investigated the association between the 3-month postoperative sense of coherence and the 5-year postoperative outcome of decompressive surgery for lumbar spinal stenosis. The participants with a lower sense of coherence at the 3-month follow-up had a poorer functional ability and lower satisfaction with surgery, higher pain ratings, lower life satisfaction and more depressive symptoms 5 years postoperatively. A low 3-month sense of coherence associated with greater pain and a poorer functional ability 5 years postoperatively. Evaluating sense of coherence and depressive symptoms in patients who have had lumbar spinal stenosis surgery may help in identifying those in need of enhanced support for postoperative recovery.

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