Definitions of unfavorable surgical outcomes and their risk factors based on disability score after spine surgery for lumbar spinal stenosis

OBJECT In this study, the authors aimed to identify specific risk factors for postdecompression lumbar disc herniation (PDLDH) in patients who have not undergone discectomy and/or fusion. METHODS Between 2007 and 2012, 493 patients with lumbar spinal stenosis underwent bilateral partial laminectomy without discectomy and/or fusion in a single hospital. Eighteen patients (herniation group [H group]: 15 men, 3 women; mean age 65.1 years) developed acute sciatica as a result of PDLDH within 2 years after surgery. Ninety patients who did not develop postoperative acute sciatica were selected as a control group (C group: 75 men, 15 women; mean age 65.4 years). Patients in the C group were age and sex matched with those in the H group. The patients in the groups were also matched for decompression level, number of decompression levels, and surgery date. The radiographic variables measured included percentage of slippage, intervertebral angle, range of motion, lumbar lordosis, disc height, facet angle, extent of facet removal, facet degeneration, disc degeneration, and vertebral endplate degeneration. The threshold for PDLDH risk factors was evaluated using a continuous numerical variable and receiver operating characteristic curve analysis. The area under the curve was used to determine the diagnostic performance, and values greater than 0.75 were considered to represent good performance. RESULTS Multivariate analysis revealed that preoperative retrolisthesis during extension was the sole significant independent risk factor for PDLDH. The area under the curve for preoperative retrolisthesis during extension was 0.849; the cutoff value was estimated to be a retrolisthesis of 7.2% during extension. CONCLUSIONS The authors observed that bilateral partial laminectomy, performed along with the removal of the posterior support ligament, may not be suitable for lumbar spinal stenosis patients with preoperative retrolisthesis greater than 7.2% during extension.

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Prognostic Factors for Surgical Outcomes Including Preoperative Total Knee Replacement and Knee Osteoarthritis Status in Female Patients With Lumbar Spinal Stenosis

Journal of Spinal Disorders & Techniques ◽

10.1097/bsd.0b013e31828d003d ◽

2015 ◽

Vol 28 (2) ◽

pp. 47-52 ◽

Cited By ~ 2

Author(s):

Byung Ho Lee ◽

Tae-Hwan Kim ◽

Hyun-Soo Chong ◽

Seung-Hwan Lee ◽

Jin-Oh Park ◽

...

Keyword(s):

Prognostic Factors ◽

Total Knee Replacement ◽

Knee Osteoarthritis ◽

Spinal Stenosis ◽

Knee Replacement ◽

Lumbar Spinal Stenosis ◽

Surgical Outcomes ◽

Female Patients ◽

Total Knee ◽

Lumbar Spinal

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The ASSI Monographs: Complications in spine surgery, ankylosing spondylitis, lumbar spinal stenosis

Indian Journal of Orthopaedics ◽

10.4103/ortho.ijortho_263_18 ◽

2018 ◽

Vol 52 (4) ◽

pp. 441 ◽

Cited By ~ 1

Author(s):

AnilK Jain

Keyword(s):

Ankylosing Spondylitis ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Spine Surgery ◽

Lumbar Spinal

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Prospective analysis of surgical outcomes in patients undergoing decompressive laminectomy and posterior instrumentation for degenerative lumbar spinal stenosis

Acta Orthopaedica et Traumatologica Turcica ◽

10.3944/aott.2010.2278 ◽

2010 ◽

pp. 235-240 ◽

Cited By ~ 12

Author(s):

Ioannis Gelalis

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Surgical Outcomes ◽

Posterior Instrumentation ◽

Prospective Analysis ◽

Decompressive Laminectomy ◽

Degenerative Lumbar Spinal Stenosis ◽

Lumbar Spinal

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Surgical Management of Lumbar Spinal Stenosis in Patients Over 80 : Is There an Increased Risk ?

10.21203/rs.3.rs-1017167/v1 ◽

2021 ◽

Author(s):

frédérick rault ◽

Anaïs R Briant ◽

Thomas Gaberel ◽

Hervé Kamga ◽

Evelyne Emery

Keyword(s):

Risk Factors ◽

Elderly Patients ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Heart Diseases ◽

The Elderly ◽

Lumbar Spine Surgery ◽

Increased Risk ◽

History Of ◽

Lumbar Spinal

Abstract Introduction:Management of lumbar spinal stenosis (LSS) represents the first cause of spinal surgery for the elderly and will increase with the aging population. Although the surgery improves quality of life, the procedure involves anaesthetic and operative risks. The aim of this study was to assess whether the postoperative complications rate was higher for elderly patients and to find confounding factors.Material and MethodsWe conducted a retrospective study including all LSS surgeries between 2012 and 2020 at the University Hospital of Caen. We compared two populations opposing patients aged over 80 with others. The primary endpoint was the occurrence of a severe complication (SC). Minor complications were the secondary endpoint. Comorbidities, history of lumbar spine surgery and surgical characteristics were recorded.Results996 patients undergoing surgery for degenerative LSS were identified. Patients over 80 were significantly affected by additional comorbidities: hypertension, heart diseases, higher age-adjusted comorbidity Charlson score, ASA score and use of anticoagulants. Knee-chest position was preferred for younger patients. Older patients underwent a more extensive decompression and had more incidental durotomies. 5.2% of patients presented SC. Age over 80 did not appear to be a significant risk factor for SC, but minor complications increased. Multivariate analysis showed that heart diseases, history of laminectomy, AA-CCI, and accidental durotomies were independent risk factors for SC.ConclusionSurgical management for lumbar spinal stenosis is not associated to a higher rate of severe complications for patients over 80 years of age. However, preoperative risk factors should be investigated to warn the elderly patients that the complications risk is increased although an optimal preparation is the way to avoid them.

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