scholarly journals LUMBAR SPINE SURGERY. IMPORTANCE OF SAGITTAL BALANCE IN THE QUALITY OF LIFE OF PATIENTS

2016 ◽  
Vol 15 (1) ◽  
pp. 48-51 ◽  
Author(s):  
Luiz Claudio Lacerda Rodrigues ◽  
Adalberto Bortoletto ◽  
Rodrigo Nakao ◽  
Virgilio Serquiz de Azevedo ◽  
Rafael Maurcio Beletato ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Lumbar Spine ◽  
Lumbar Spine Surgery ◽  
P Value ◽  
Sacral Slope ◽  
Lumbosacral Region ◽  
Degenerative Lumbar Diseases ◽  
Spinopelvic Balance

ABSTRACT Objective: To evaluate whether performing surgery in degenerative diseases of the lumbar spine modify the spinopelvic balance and influences the clinical outcome and the quality of life of patients. Methods: The spinopelvic balance was evaluated in 25 patients using plain radiographs of the lumbosacral region including the proximal femur, as well as evaluating the quality of life on two separated occasions. Results: The measure of spinopelvic balance was obtained by averaging the angles of sacral slope, pelvic version and pelvic incidence. Mean preoperative angles were 59.88º, 22.84º, and 37.44º, respectively, and the mean postoperative values were 61.56º, 24.64º, and 37.32º, respectively. Regarding the questionnaires on quality of life, the Oswestry index showed mean preoperative values of 46.24, characterized as severe disability and mean postoperative values of 13.29 denoting satisfactory response after surgical treatment. The SF-36 questionnaire showed important and significant improvement in quality of life in different domains, with the exception of physical limitation and social aspects, with a p-value of 0.02 and 0.025, respectively. Conclusion: Patients undergoing surgical treatment of degenerative lumbar diseases showed no significant changes in the spinopelvic balance, but showed significant improvement in quality of life after surgery.

Cosmetic and functional outcomes following paramedian and anterolateral retroperitoneal access in anterior lumbar spine surgery

2008 ◽  
Vol 9 (5) ◽  
pp. 454-465 ◽  
Author(s):  
Jay Jagannathan ◽  
Ekawut Chankaew ◽  
Peter Urban ◽  
Aaron S. Dumont ◽  
Charles A. Sansur ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lumbar Spine ◽  
Wound Complication ◽  
Research Society ◽  
Retroperitoneal Approach ◽  
Lumbar Spine Surgery ◽  
Anterolateral Approach ◽  
Scoliosis Research Society ◽  
Cosmetic Outcomes

Object In this paper, the authors review the functional and cosmetic outcomes and complications in 300 patients who underwent treatment for lumbar spine disease via either an anterior paramedian or conventional anterolateral retroperitoneal approach. Methods Seven surgeons performed anterior lumbar surgeries in 300 patients between August 2004 and December 2006. One hundred and eighty patients were treated with an anterior paramedian approach, and 120 patients with an anterolateral retroperitoneal approach. An access surgeon was used in 220 cases (74%). Postoperative evaluation in all patients consisted of clinic visits, assessment with the modified Scoliosis Research Society–30 instrument, as well as a specific questionnaire relating to wound appearance and patient satisfaction with the wound. Results At a mean follow-up of 31 months (range 12–47 months), the mean Scoliosis Research Society–30 score (out of 25) was 21.2 in the patients who had undergone the anterior paramedian approach and 19.4 in those who had undergone the anterolateral retroperitoneal approach (p = 0.005). The largest differences in quality of life measures were observed in the areas of pain control (p = 0.001), self-image (p = 0.004), and functional activity (p = 0.003), with the anterior paramedian group having higher scores in all 3 categories. Abdominal bulging in the vicinity of the surgical site was the most common wound complication observed and was reported by 22 patients in the anterolateral retroperitoneal group (18%), and 2 patients (1.1%) in the anterior paramedian group. Exposures of ≥ 3 levels with the anterolateral approach were associated with abdominal bulging (p = 0.04), while 1- or 2-level exposures were not (p > 0.05). Overall satisfaction with incisional appearance was higher in patients with an anterior paramedian incision (p = 0.001) and with approaches performed by an access surgeon (p = 0.004). Conclusions Patients who undergo an anterior paramedian approach to the lumbar spine have a higher quality of life and better cosmetic outcomes than patients undergoing an anterolateral retroperitoneal approach.

scholarly journals Assessment of the quality of life of patients after parathyroidectomy from standard and small access

2021 ◽  
Vol 67 (2) ◽  
pp. 40-48
Author(s):  
A. V. Ogorodnikov ◽  
S. S. Kharnas
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Calculated Data ◽  
Long Term Results ◽  
Graphical Form ◽  
Statistical Criterion ◽  
P Value ◽  
Analog Scale ◽  
Linear Analog

BACKGROUND. Primary hyperparathyroidism (PGPT) is an increase in the secretory activity of the parathyroid glands (OSH), due to their tumor or hyperplastic changes. Due to the lack of an effective alternative to the treatment of PGPT, the surgical method is still the only correct tactical solution for the management of patients with an established diagnosis of PGPT. The paper presents the long-term results and assessment of the quality of life of patients who underwent surgical treatment from standard and small access. The results obtained showed the promise of a sparing approach to the treatment of PGPT caused by LV adenoma.AIM. To study the effectiveness of surgical treatment of patients with PGPT based on the assessment of the quality of life of patients who underwent parathyroidectomy from standard and small access.MATERIALS AND METHODS. A retrospective study of the quality of life of patients with PGPT after surgical treatment was conducted using the SF-36 questionnaire and the linear analog scale (LAS). Statistical data processing is performed in the R programming language using the FMSB package. The quantitative parameters were presented as median (Median) and interquartile range (25th (1st Qu) — lower quartile and 75th (3rd Qu ) — upper quartile). As a nonparametric statistical criterion, the Mann–Whitney U-test was used, on the basis of which the p-value was calculated. The calculated data of the research results are presented in graphical form — in the form of bar charts, spider plot and barplot.RESULTS. This study involved 264 patients. The patients were divided into 2 groups: GR1 — patients operated from the Kocher access with mandatory revision of all 4 OSH, GR2 — patients who received surgical treatment from the small access with the removal of the altered OSH, without revision of the remaining OSH. When analyzing the quality of life of patients before surgery, there were no statistically significant differences in the groups in terms of PF (Physical Functioning) and VT (Vitality). Small-access parathyroidectomy (patients with GR 2) significantly improved the quality of life in the GH (General Health) and VT (Vitality) domains. The analysis of LAS before surgery between the groups showed no statistically significant differences, while after surgical treatment, the indicators on the linear analog scale differ in the direction of improvement in GR2.CONCLUSION. The results obtained in the course of the study showed the promise of a gentle approach to the treatment of PGPT caused by LV adenoma, which is reflected in higher quality of life indicators.

95. Response Shift in Quality of Life Outcomes Measurements in Cervical and Lumbar Spine Surgery Patients

2009 ◽  
Vol 9 (10) ◽  
pp. 50S
Author(s):  
Ashok Biyani ◽  
Tomoya Terai ◽  
Melissa Hansen ◽  
David Ross ◽  
Matthew Gray ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lumbar Spine ◽  
Spine Surgery ◽  
Response Shift ◽  
Lumbar Spine Surgery ◽  
Life Outcomes ◽  
Quality Of Life Outcomes

scholarly journals The Predictive Value of Preoperative Health-Related Quality-of-Life Scores on Postoperative Patient-Reported Outcome Scores in Lumbar Spine Surgery

2017 ◽  
Vol 8 (2) ◽  
pp. 156-163 ◽  
Author(s):  
Hwee Weng Dennis Hey ◽  
Nan Luo ◽  
Sze Yung Chin ◽  
Eugene Tze Chun Lau ◽  
Pei Wang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lumbar Spine ◽  
Predictive Value ◽  
Lumbar Spine Surgery ◽  
Health Related Quality ◽  
Point Increase ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related

Study Design: A single-center, retrospective cohort study. Objective: To predict patient-reported outcomes (PROs) using preoperative health-related quality-of-life (HRQoL) scores by quantifying the correlation between them, so as to aid selection of surgical candidates and preoperative counselling. Methods: All patients who underwent single-level elective lumbar spine surgery over a 2-year period were divided into 3 diagnosis groups: spondylolisthesis, spinal stenosis, and disc herniation. Patient characteristics and health scores (Oswestry Low Back Pain and Disability Index [ODI], EQ-5D, and Short Form-36 version 2 [SF-36v2]) were collected at 6 and 24 months and compared between the 3 diagnosis groups. Multivariate modelling was performed to investigate the predictive value of each parameter, particularly preoperative ODI and EQ-5D, on postoperative ODI and EQ-5D scores for all the patients. Results: ODI and EQ-5D at 6 and 24 months improved significantly for all patients, especially in the disc herniation group, compared to the baseline. The magnitude of improvement in ODI and EQ-5D was predictable using preoperative ODI, EQ-5D, and SF-36v2 Mental Component Score. At 6 months, 1-point baseline ODI predicts for 0.7-point increase in changed ODI, and a 0.01-point increase in baseline EQ-5D predicts for 0.01-point decrease in changed EQ-5D score. At 24 months, 1-point baseline ODI predicts for 1-point increase in changed ODI, and a 0.01-point increase in baseline EQ-5D predicts for 0.009-point decrease in changed EQ-5D. A younger age is shown to be a positive predictor of ODI at 24 months. Conclusions: Poorer baseline health scores predict greater improvement in postoperative PROs at 6 and 24 months after the surgery. HRQoL scores can be used to decide on surgery and in preoperative counselling.

scholarly journals MULTICENTER ANALYSIS OF THE RESULTS OF APPLICATION OF DIRECT LATERAL INTERBODY FUSION (DLIF) AND TRANSCUTANEOUS TRANSPEDICULAR FIXATION IN PATIENTS WITH DEGENERATIVE DISC DISEASES OF THE LUMBAR SPINE

2017 ◽  
Vol 72 (2) ◽  
pp. 149-158
Author(s):  
V. A. Byvaltsev ◽  
A. A. Kalinin ◽  
S. K. Akshulakov ◽  
A. E. Krivoshein ◽  
T. T. Kerimbayev ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Lumbar Spine ◽  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Degenerative Disc ◽  
Pedicle Fixation ◽  
Multicenter Analysis ◽  
Lateral Interbody

Background: The technique of lateral lumbar interbody fusion for the surgical treatment of patients with degenerative diseases of the lumbar spine was developed in the early 2000s. But at the same time in modern literature there is no uniform approach to the use this technique, clinical outcomes and radiological findings are contradictory. Aims: to conduct a multicenter analysis of clinical outcomes and instrumental data of direct lateral interbody fusion (DLIF) approach combined with transcutaneous pedicle fixation in patients with single-level degenerative disc diseases of the lumbar spine. Materials and methods: The study included 103 patients (63 men and 40 women, mean age 45.8±9.7 years) who underwent surgery followed by DLIF transcutaneous pedicle fixation. The surgery was performed at neurosurgical and vertebrological departments in Irkutsk (Russia), Omsk (Russia), and Astana (Kazakhstan). Dynamic observation and comprehensive clinical and instrumental evaluation of the treatment results were carried out for an 18-month period after surgery. Results: After the simultaneous decompressive-stabilizing intervention, in all patients we detected a decrease in the severity of pain syndrome on VAS — from 6.9±1.6 to 1.7±1.2 cm (p0.001), and improved quality of life index (Oswestry) — from 21.3±6.8 to 12.3±4.4% (p0.001). The instrumental methods of examination determined the effective indirect decompression: an increase in the size of interbody gap in the middle of its department compared with the preoperative value from 8.6±3.1 to 15.7±4.2 mm (p0.001) and an increase in the area of the intervertebral foramen (on the left with an average of 98.7±32.3 and 156.8±45.1 mm2, p0.001; on the right —99.7±37.3 to 153.4±38.7 mm2, p0.001). We also registered the restoration of both the segmental (from 10.2±3.8 to 13.6±6.7°, p0.001) and regional (from 32.8±5.9 to 48.2±7.3°, р0.001) lumbar lordosis. Complete interbody fusion was diagnosed in 87 (86.4%) patients. Complications were observed in 8.7% of cases. Conclusions: DLIF technique combined with transcutaneous transpedicular stabilization has high clinical efficacy confirmed by significant reduction in the severity of pain according to VAS. The studied approach improves the quality of life of patients by Oswestry index and reveals a low number of postoperative complications. The described simultaneous minimally invasive method of surgical treatment in patients with degenerative disc diseases allows to restore the sagittal profile of the lumbar spine and implement an effective stabilization of the operated vertebral-motor segments with a high degree of formation of interbody bone block.

scholarly journals RESULTS OF COMBINED FIXATION OF SCOLIOTIC SPINAL DEFORMITY IN ADULTS

2010 ◽  
Vol 16 (2) ◽  
pp. 89-92
Author(s):  
V. D. Usikov ◽  
D. A. Ptashnikov ◽  
O. A. Smekalenkov ◽  
D. A. Mikhailov
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Lumbar Spine ◽  
Spinal Deformity ◽  
Dynamic Stabilization ◽  
Adult Patients ◽  
Spinal Fixation

The results of surgical treatment of adult patients with scoliosis in the form of different fixation of L5-S1 segment. The best results were obtained in patients who underwent combined spinal fixation (transpedicular system and the system interspinous dynamic stabilization). In this group good indicators of quality of life of patients in the form of lack of pain and preservation of the normal volume movements in the lumbar spine were received.

Reliability and Validity of Adapted Russian Version of Hospital for Special Surgery Lumbar Spine Surgery Expectations Survey

2021 ◽  
pp. 155633162110540
Author(s):  
Anton Denisov ◽  
Nikita Zaborovskii ◽  
Vladimir Solovyov ◽  
Mikael Mamedov ◽  
Dmitrii Mikhaylov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lumbar Spine ◽  
Internal Consistency ◽  
Spine Surgery ◽  
Reliability And Validity ◽  
Lumbar Spine Surgery ◽  
Russian Version ◽  
Special Surgery ◽  
Hospital For Special Surgery

Background: Patients’ expectations are an important determinant in their decision to undergo lumbar spinal surgery—particularly their expectations of recovery after surgery. The Hospital for Special Surgery Lumbar Spine Surgery Expectations Survey (HSS-LSSES) is one tool used to assess this; however, the original version was only available in English. Objective: We sought to evaluate the reliability and validity of a translated and adapted Russian-language version of the HSS-LSSES. Methods: This was a prospective study of 91 patients with degenerative disc disease who underwent lumbar spine surgery with instrumented fixation at a single institution in Saint Petersburg, Russia. Patients were recruited between December 2019 and February 2021 and asked about their expectations of surgery with a translated and adapted Russian version of the HSS-LSSES. To analyze construct validity, participants also completed disease-specific and general quality-of-life scales (Oswestry Disability Index, European Quality of Life–5 Dimensions, and 36-item Short-Form Health Survey). Intraclass correlation coefficients (ICCs; 2-way random effects model, absolute agreement) were used to determine test-retest reliability of the total score of the Russian HSS-LSSES. Internal consistency was evaluated through the estimation of Cronbach’s alpha between the test and retest response of the questionnaire. Results: The test-retest stability of the Russian HSS-LSSES evaluated through the estimation of ICC was found to have good stability. The instrument was shown to have high internal consistency. Conclusion: This study demonstrates that a translated and adapted Russian version of HSS-LSSES had good internal consistency, reliability, construct validity, and no floor and ceiling effects. Therefore, we recommend its use as a tool for evaluating Russian-speaking patients’ expectations before lumbar spine surgery.

scholarly journals Patient-specific prediction model for clinical and quality-of-life outcomes after lumbar spine surgery

2021 ◽  
pp. 1-9
Author(s):  
Daniel Lubelski ◽  
James Feghali ◽  
Amy S. Nowacki ◽  
Vincent J. Alentado ◽  
Ryan Planchard ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lumbar Spine ◽  
Spine Surgery ◽  
Degenerative Disease ◽  
Lumbar Spine Surgery ◽  
Indication For Surgery ◽  
Duration Of Symptoms ◽  
Patient Demographics ◽  
Ed Visits

OBJECTIVEPatient demographics, comorbidities, and baseline quality of life (QOL) are major contributors to postoperative outcomes. The frequency and cost of lumbar spine surgery has been increasing, with controversy revolving around optimal management strategies and outcome predictors. The goal of this study was to generate predictive nomograms and a clinical calculator for postoperative clinical and QOL outcomes following lumbar spine surgery for degenerative disease.METHODSPatients undergoing lumbar spine surgery for degenerative disease at a single tertiary care institution between June 2009 and December 2012 were retrospectively reviewed. Nomograms and an online calculator were modeled based on patient demographics, comorbidities, presenting symptoms and duration of symptoms, indication for surgery, type and levels of surgery, and baseline preoperative QOL scores. Outcomes included postoperative emergency department (ED) visit or readmission within 30 days, reoperation within 90 days, and 1-year changes in the EuroQOL-5D (EQ-5D) score. Bootstrapping was used for internal validation.RESULTSA total of 2996 lumbar surgeries were identified. Thirty-day ED visits were seen in 7%, 30-day readmission in 12%, 90-day reoperation in 3%, and improvement in EQ-5D at 1 year that exceeded the minimum clinically important difference in 56%. Concordance indices for the models predicting ED visits, readmission, reoperation, and dichotomous 1-year improvement in EQ-5D were 0.63, 0.66, 0.73, and 0.84, respectively. Important predictors of clinical outcomes included age, body mass index, Charlson Comorbidity Index, indication for surgery, preoperative duration of symptoms, and the type (and number of levels) of surgery. A web-based calculator was created, which can be accessed here: https://riskcalc.org/PatientsEligibleForLumbarSpineSurgery/.CONCLUSIONSThe prediction tools derived from this study constitute important adjuncts to clinical decision-making that can offer patients undergoing lumbar spine surgery realistic and personalized expectations of postoperative outcome. They may also aid physicians in surgical planning, referrals, and counseling to ultimately lead to improved patient experience and outcomes.

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