scholarly journals Clinical and radiographic outcomes for microsurgical unilateral laminotomy for bilateral decompression of lumbar spinal stenosis for elderly patients-A retrospective cohort study

2020 ◽  
Author(s):  
Bin Lv
Keyword(s):  
Elderly Patients ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Short Form ◽  
Short Form Health Survey ◽  
Radiographic Outcomes ◽  
Form Health ◽  
Lumbar Spinal ◽  
Short Form Health

Abstract BackgroundRecently, unilateral laminotomy for bilateral decompression (ULBD) has become a alternative to conventional decompression for symptomatic lumbar spinal stenosis (LSS),and this minimally invasive surgical technique has shown a satisfactory outcomes and low complications. However, the influence of old age on the risk of postoperative complications and clinical outcome is not well understood.OBJECTIVEThe purpose of this study was to evaluate clinical and radiographic outcomes and complication rates after ULBD in elderly patients.Study DesignSingle center retrospective observational study.SettingAll data was from the affiliated people's hospital of Jiangsu University.METHODSIn this study, 39 elderly patients were treated for lumbar spinal stenosis by ULBD between January 2016 and January 2018. Follow-up consisted of radiologic investigations, Visual Analog Scale, Oswestry Disability Index, and 36-Item Short-Form Health Survey at 6 and 12 months postoperatively. Preoperative comorbidity, postoperative complications and revision surgery rates were also analyzed.RESULTSThere were 12 female patients and 27 male patients with a mean age of 75.83 ± 9.16 years. 20 patients had one levels of spinal stenosis, 13 patients had two levels of stenosis, 6 patients had three levels of stenosis. Average follow-up time was 14.6 ± 7.8 months (range, 6–24 months), Total complications were 10.2%(4/39),and reoperation rate was 2.5%(1/39). Oswestry Disability Index scores decreased significantly (from 32.26 ± 6.82 to 11.44 ± 2.50 at 6 months and 10.56 ± 2.29 at 12 months), and 36-Item Short-Form Health Survey parameter scores demonstrated a significant improvement in the follow-up results.LimitationA multi-center study is recommended to confirm our findings and explore the factors related to clinical and radiographic outcomes.CONCLUSIONSULBD for lumbar spinal stenosis is a safe and effective treatment for elderly patients, improves these patients’ quality of life and does not pose an increased risk of complications.

scholarly journals Long-term Clinical Outcomes and Quality of Life in Elderly Patients Treated with Interspinous Devices for Lumbar Spinal Stenosis

2017 ◽  
Vol 79 (02) ◽  
pp. 139-144 ◽  
Author(s):  
Massimo Miscusi ◽  
Stefano Forcato ◽  
Alessandro Ramieri ◽  
Filippo Polli ◽  
Antonino Raco ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Spinal Stenosis ◽  
Local Anesthesia ◽  
Lumbar Spinal Stenosis ◽  
Short Form ◽  
Meaningful Improvement ◽  
Lumbar Spinal

Background and Objective Lumbar spinal stenosis (LSS) is a common degenerative condition that occurs in the spine with increasing age. Clinically, LSS causes a progressive reduction in walking autonomy, resulting in a poor quality of life and impaired functional capacity. The aim of this study was to evaluate the clinical outcome and quality of life of elderly patients presenting with LSS and associated comorbidities after a 5-year follow-up who were treated with an interspinous process device (IPD). Material and Methods Sixty patients > 75 years of age presenting with symptomatic degenerative LSS were included. All were treated with an IPD under local anesthesia. American Society of Anesthesiology score, Zurich Claudication Questionnaire, and Short Form 36 were evaluated pre- and postoperatively and at the follow-up visit each year for 5 years. Results The mean surgery time while under local anesthesia was 20 minutes. Forty-eight patients were followed for 5 years. Significant clinical improvements in all outcome scores (p < 0.05) both postoperatively or at follow-up were found. Conclusions IPD seems to be an effective and safe treatment for LSS in elderly patients with general comorbidities. In our study, all followed up patients had a meaningful improvement of their quality of life even at 5 years after surgery.

Quality of life in elderly patients with dizziness: analysis of the short-form health survey in 197 patients

2005 ◽  
Vol 125 (1) ◽  
pp. 55-59 ◽  
Author(s):  
Li-chi Hsu ◽  
Han-hwa Hu ◽  
Wen-jang Wong ◽  
Shuu-jiun Wang ◽  
Yun-on Luk ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Health Survey ◽  
Short Form ◽  
Short Form Health Survey ◽  
Form Health ◽  
Short Form Health

Endoscopic posterior decompression under local anesthesia for degenerative lumbar spinal stenosis

2018 ◽  
Vol 29 (6) ◽  
pp. 661-666 ◽  
Author(s):  
Myung Soo Youn ◽  
Jong Ki Shin ◽  
Tae Sik Goh ◽  
Seung Min Son ◽  
Jung Sub Lee
Keyword(s):  
Spinal Stenosis ◽  
Local Anesthesia ◽  
Lumbar Spinal Stenosis ◽  
Short Form ◽  
Posterior Decompression ◽  
Mean Values ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Sf 36 ◽  
Lumbar Spinal

OBJECTIVEVarious minimally invasive techniques have been described for the decompression of lumbar spinal stenosis (LSS). However, few reports have described the results of endoscopic posterior decompression (EPD) with laminectomy performed under local anesthesia. This study aimed to evaluate the clinical and radiological outcomes of EPD performed under local anesthesia in patients with LSS and to compare the procedural outcomes in patients with and without preoperative spondylolisthesis.METHODSFifty patients (28 female and 22 male) who underwent EPD under local anesthesia were included in this study. Patients were assessed before surgery and were followed up with regular outpatient visits (at 1, 3, 6, 12, and 24 months postoperatively). Clinical outcomes were evaluated using the visual analog scale (VAS), Oswestry Disability Index (ODI), and the 36-Item Short Form Survey (SF-36) outcome questionnaire. Radiological outcomes were assessed by measuring lumbar lordosis, disc-wedging angle, percentage of vertebral slippage, and disc height index on plain standing radiographs.RESULTSThe VAS, ODI, and SF-36 scores were significantly improved at 1 month after surgery compared to the baseline mean values, and the improved scores were maintained over the 2-year follow-up period. Radiological progression was found in 2 patients during the follow-up period. Patients with and without preoperative spondylolisthesis had no significant differences in their clinical and radiological outcomes.CONCLUSIONSEPD performed under local anesthesia is effective for LSS treatment. Similar favorable outcomes can be obtained in patients with and without preoperative spondylolisthesis using this approach.

scholarly journals Prospective Associations of the Short Form Health Survey Vitality Scale and Changes in Body Mass Index and Obesity Status

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Cathrine Lawaetz Wimmelmann ◽  
Emilie Rune Hegelund ◽  
Anna Paldam Folker ◽  
Emilie Just-Østergaard ◽  
Merete Osler ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Mass Index ◽  
Body Mass ◽  
Short Form ◽  
Baseline Body Mass Index ◽  
Short Form Health Survey ◽  
Form Health ◽  
Vitality Scale ◽  
Short Form Health

Objectives. The objectives of the current study were to prospectively investigate the predictive value of the vitality scale of the Short Form Health Survey for changes in body mass index and development of obesity. Methods. The study population comprised 2864 (81.5%) men and 648 (18.5%) women from the Metropolit Project and the Danish Longitudinal Study on Work, Unemployment and Health, who participated in a follow-up examination in 2009–2011 corresponding to a follow-up period of 3–7 years. Associations of vitality with body mass index and obesity were investigated separately for men and women in linear and logistic regression models adjusting for age, baseline body mass index, education, physical activity, smoking, and obesity-related diseases. Results. Vitality was significantly associated with change in body mass index among men (p<0.001) and women (p<0.05) gaining weight after adjusting for age, baseline body mass index, education, physical activity, smoking, and obesity-related diseases. No significant associations of vitality with BMI change were observed among individuals maintaining or losing weight during the follow-up period. Furthermore, vitality significantly predicted development of obesity among women. Conclusion. The study indicates that vitality is of predictive value for increases in BMI over time among individuals gaining weight and may further predict the development of obesity among women. This identification of poor vitality as a potential risk indicator for weight gain and development of obesity may be beneficial in clinical practice.

PFLEGEprevent – Präventiv der Arbeitsbelastung von Pflegekräften begegnen. Ergebnisse einer randomisiert kontrollierten Interventionsstudie zur Wirksamkeit einer Präventionsmaßnahme für Pflegekräfte

2020 ◽  
Author(s):  
Veronika Ehegartner ◽  
Michaela Kirschneck ◽  
Eva M Wilhelm ◽  
Dieter Frisch ◽  
Angela Schuh ◽  
...  
Keyword(s):  
Perceived Stress ◽  
Short Form ◽  
Well Being ◽  
Short Form Health Survey ◽  
Work Ability Index ◽  
Stress Scale ◽  
Form Health ◽  
Ability Index ◽  
Short Form Health

Zusammenfassung Hintergrund Pflegekräfte in Deutschland sind zunehmend von physischen und psychischen Belastungen beeinträchtigt, was sich negativ in den Krankheitstagen und Frühberentungszahlen niederschlägt. Im Projekt PFLEGEprevent wurde ein Präventionsprogramm entwickelt, das auf die speziellen Bedürfnisse des Pflegepersonals ausgerichtet ist, damit deren Ressourcen im Umgang mit Arbeitsbelastungen und Herausforderungen des beruflichen Alltags gestärkt werden. Das Präventionsprogramm wurde in einer RCT mit Pflegekräften implementiert und auf seine Wirksamkeit in den Bereichen Stress, Arbeitsfähigkeit und Lebensqualität hin evaluiert. Methodik Die randomisiert kontrollierte Interventionsstudie wurde im Wartegruppendesign mit 6 Erhebungszeitpunkten über 9 Monate durchgeführt. Die Datenerhebung der Zielgrößen erfolgte über validierte Instrumente: Perceived Stress Questionnaire (PSQ), Perceived Stress Scale (PSS), Work Ability Index (WAI), Erholungs-Belastungs-Fragebogen für den Arbeitskontext (EBF-Work 27), Short-Form-Health Survey (SF-12) und WHO-Five Well-Being Index (WHO-5). Neben deskriptiven Analysen wurde der t-Test für unabhängige Stichproben verwendet, um die Veränderungen in der primären und den sekundären Zielgrößen zwischen den Studiengruppen zu vergleichen. Ergebnisse Es nahmen 125 (92% weiblich, Durchschnittsalter 46,7 Jahre) Pflegekräfte an der Studie teil. Es zeigten sich signifikante Gruppenunterschiede in den Veränderungen der Zielgröße zu den Follow-up-Messungen bis zu 9 Monaten. Besonders das Stressempfinden reduzierte sich in der Interventionsgruppe langfristig. Das allgemeine Wohlbefinden in dieser Gruppe verbesserte sich zu allen Erhebungszeitpunkten signifikant zum Ausgangswert. Schlussfolgerung Die Evaluation des Präventionsprogrammes zeigte noch nach 9 Monaten einen positiven Effekt in der gemessenen Zielgröße PSQ zum Stresserleben. In den weiteren Zielgrößen konnten signifikante Gruppenunterschiede zu den Nacherhebungszeitpunkten nach 1 und 3 Monaten gezeigt werden.

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

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.

scholarly journals The Therapeutic Evaluation of Spinal Canal Decompression by Using the TBEIS Technique in the Treatment of Lumbar Spinal Stenosis

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Kemin You ◽  
Bo Li ◽  
Hongze Chang ◽  
Yan Zhang ◽  
Feng Cai ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Clinical Efficacy ◽  
The Elderly ◽  
Clinical Effects ◽  
Vas Scores ◽  
Immediate Surgery ◽  
Lumbar Spinal

Objective. To evaluate the clinical efficacy of the percutaneous endoscopic Transforaminal Broad Easy Immediate Surgery (TBEIS) technology in elderly patients with lumbar spinal stenosis (LSS). Methods. From February 2016 to May 2018, 35 elderly patients with LSS were treated with the TBEIS technique. There were 23 males and 12 females, aged from 53 to 72 years with a median age of 63.1 years. Preoperative, 1 day, and 1 and 12 months postoperative visual analogue scale (VAS) scores and Oswestry Disability Index (ODI) were statistically analyzed. The modified MacNab criterion was used to assess the clinical effects. The radiological outcomes were evaluated by X-ray and computed tomography (CT). Results. All of the operations were successful. The operative time ranged from 120 to 170 min with a median time of 148 min. All of the patients were followed up for 12 to 38 months with a median follow-up of 18 months. Preoperative, 1 day, and 1 and 12 months postoperative VAS leg scores were 6.91±0.98, 1.69±0.68, 1.23±0.59, and 0.91±0.61, respectively, and the VAS back scores improved from 4.51±0.82 to 0.66±0.68. The ODI scores were 63.82±7.59, 38.79±6.36, 24.79±3.90, and 11.33±3.92, respectively. Postoperative scores of VAS and ODI were obviously improved (P<0.01). According to the modified MacNab criteria used to evaluate the clinical effects, 11 cases achieved excellent results, 18 cases achieved good results, 4 cases achieved fair results, and 2 cases achieved poor results. There were no neurovascular injury and other complications. Conclusions. Treatment of LSS in the elderly patients by the TBEIS technology has good clinical efficacy, and the technique is safe and minimally invasive.

scholarly journals Clinical Efficacy and Rehabilitation of Microscopic “Over the Top” for Bilateral Decompression in Degenerative Lumbar Stenosis: A Retrospective Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Bin Lv ◽  
Sixin Sun ◽  
Haosheng Wang ◽  
Li Xiao ◽  
Tao Xu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Complications ◽  
Clinical Efficacy ◽  
Geriatric Patients ◽  
Short Form ◽  
Short Form Health Survey ◽  
Form Health ◽  
Over The Top ◽  
Short Form Health

Background. Recently, “over the top” (also called ULBD; microscopic unilateral laminotomy for bilateral decompression) is a less invasive technique for symptomatic degenerative lumbar spinal stenosis (LSS), and this minimally invasive surgical technique has demonstrated favorable therapeutic outcomes. However, the risk of postoperative complications remains controversial. Objective. This study is aimed at determining the clinical efficacy and complication and rehabilitation of the microscopic “over the top” for degenerative LSS in geriatric patients. Study Design. This was a retrospective study. Setting. All data were obtained from the People’s Hospital of a University. Methods. A retrospective analysis of 39 consecutive elderly patients treated for LSS by microscopic “over the top” between January 2016 and January 2018 was performed. A postoperative rehabilitation program for geriatric patients with restricted weight-bearing was instituted after the microscopic “over the top” treatment. Estimated blood loss, duration of operation, length of hospitalization, and total complications were also evaluated. The CT and MRI examinations of the lumbar spine were collected to evaluate the completeness of the nerve decompression. Clinical data were assessed at 6 months and 12 months after operation utilizing the visual analog scale (VAS), Oswestry Disability Index (ODI), and 36-Item Short-Form Health Survey (SF-36). Preoperative comorbidities, complications, and revision surgery were also recorded. Results. We enrolled a total of 39 degenerative LSS patients (27 male and 12 female patients, mean age of 75.8 ± 9.2 years). Twenty patients had one-level of degenerative LSS; thirteen patients had two-level of LSS; six patients had three-level of LSS. The average follow-up time in our study was 14.6 ± 7.8 months (range, 6-24 months). The overall complication rate was 10.2% (4/39), and the reoperation rates at one year were 2.5% (1/39). VAS back and leg pain score at 6 months were decreased to 1.8 ± 0.7 and 1.4 ± 0.6 , respectively, and remained at 1.9 ± 0.3 and 1.2 ± 0.2 at 12 months, respectively. ODI scores improved significantly from 32.26 ± 6.82 to 11.44 ± 2.50 at 6 months and 10.56 ± 2.29 at 12 months. 36-Item Short-Form Health Survey scores revealed a significant improvement throughout follow-up. Postoperative complications included dural tear ( n = 2 ), neurologic deficit ( n = 1 ), and reoperation ( n = 1 ). No infections or hematomas were reported. Limitation. Multicenter research is recommended to confirm our results and investigate the factors related to clinical and radiographic results. Conclusions. Microscopic “over the top” technique is a safe, effective option in the therapy of degenerative LSS and obtained satisfactory functional outcomes when coupled with aggressive rehabilitation, with a long recurrence-free recovery.

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