scholarly journals The Change of Lumbar Spinal Stenosis Symptoms over a Six-Year Period in Community-Dwelling People

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1116
Author(s):  
Koji Otani ◽  
Shin-ichi Kikuchi ◽  
Shoji Yabuki ◽  
Takuya Nikaido ◽  
Kazuyuki Watanabe ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Predictive Factors ◽  
Time Course ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Lumbar Spinal

Background and Objectives: The high prevalence of lumbar spinal stenosis (LSS) and its negative impact on quality of life in the elderly is well known. However, the longitudinal time course of LSS symptoms remains unclear. The purpose of this study was to clarify the longitudinal time course and associated factors of LSS symptoms over a period of six years in a community. Materials and Methods: This study was conducted with data prospectively collected in 2004 and 2010 under a retrospective design. In 2004, 1578 subjects (age range: 40 to 79 years) were interviewed on LSS symptoms using a specially designed and validated questionnaire. In 2010, a follow-up study was performed by mail, to which 789 subjects of the 2004 study population responded. Considering that the presence of osteoarthritis (OA) of the knee or hip may influence the participants’ answers in the questionnaire, analysis was performed in all 789 subjects with and 513 subjects without either knee or hip OA. Changes in LSS symptoms between the initial and the 6-year survey were investigated. Multiple logistic regression analysis was used for detecting the risk factors for LSS symptom presence at the six-year follow-up. Results: 1. At the six-year follow-up, more than half of the subjects who showed LSS symptoms at the initial analysis became LSS-negative, and 12–15% of those who were LSS-negative became LSS-positive. 2. From the multiple logistic regression analysis, a lower Roland-Morris Disability Questionnaire (RDQ) score and a positive LSS symptom at the initial analysis were detected as predictive factors of the presence of LSS symptoms at the six-year follow-up in the total number of subjects, as well as just in those who did not have either knee or hip OA. Conclusions: More than half of the subjects who were LSS-positive at their initial assessment still experienced improvement in their symptoms even after 6 years. This means that both LSS symptoms and their time course vary from person to person. Predictive factors for the presence of LSS symptoms during the six-year follow-up period were RDQ score and positive LSS symptoms.

scholarly journals Complications as important predictors of disability in ischemic stroke

2017 ◽  
Vol 36 (3) ◽  
pp. 197
Author(s):  
Rizaldy Taslim Pinzon ◽  
Rosa De Lima Renita Sanyasi
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Ischemic Stroke ◽  
Logistic Regression Analysis ◽  
Predictive Factors ◽  
Recurrent Stroke ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Cross Sectional ◽  
Stroke Registry

Background<br />Stroke is the main cause of disability and death in many countries. The high incidence of disability in stroke survivors requires special attention to determine various predictive factors of disability. This study aimed to identify the various predictive factors of disability in ischemic stroke.<br /><br />Methods<br />This study was a cross sectional study on 4510 ischemic stroke patients. Each patient’s data had been recorded in the electronic stroke registry of Bethesda Hospital. Ischemic stroke diagnosis was confirmed by brain CT scan, which was interpreted by a neurologist and a radiologist. Disability was assessed using the modified Rankin scale. Predictors of disability were assessed. Multiple logistic regression analysis was used to analyse the data. <br /><br />Results<br />The subjects were predominantly males, &gt;60 years of age, and suffered stroke for the first time. The incidence of disability was 31.5% (1420/4510). Multiple logistic regression analysis showed that the presence of complications (OR: 6.43; 95% CI: 4.74-8.73; p&lt;0.001), decreased level of consciousness (OR: 4.82; 95% CI: 3.95-5.90; p &lt;0.001), onset ³3 hours (OR: 1.93; 95% CI: 1.52-2.45; p&lt;0.001), recurrent stroke (OR: 1.63; 95% CI: 1.39-1.90; p&lt;0.001), and age &gt;60 years (OR: 1.55; 95% CI: 1.35-1.79; p&lt;0.001) were independent predictive factors of disability.<br /><br />Conclusion<br />We demonstrated that a substantial proportion of patients with ischemic stroke become disabled. And the presence of complications was the most predictive factor of disability in ischemic stroke.

scholarly journals Factors Influencing Patient Satisfaction After Decompression Surgery Without Fusion for Lumbar Spinal Stenosis

2019 ◽  
Vol 10 (5) ◽  
pp. 627-632 ◽  
Author(s):  
Yoji Ogura ◽  
Yoshiomi Kobayashi ◽  
Yoshio Shinozaki ◽  
Takahiro Kitagawa ◽  
Yoshiro Yonezawa ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Patient Satisfaction ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Logistic Regression Analysis ◽  
Leg Pain ◽  
Decompression Surgery ◽  
Satisfaction Rate ◽  
Lumbar Spinal

Study Design: Retrospective cohort study. Objectives: Decompression without fusion is a standard surgical treatment for lumbar spinal stenosis (LSS) with reasonable surgical outcomes. Nevertheless, some studies have reported low patient satisfaction (PS) following decompression surgery. The cause of the discrepancy between reasonable clinical outcomes and PS is unknown; moreover, the factors associated with PS are expected to be complex, and little is known about them. This study aimed to identify satisfaction rate and to clarify the factors related to PS following decompression surgery in LSS patients. Methods: We retrospectively reviewed 126 patients who underwent lumbar decompression with a minimum follow-up of 1 year. Patients were divided into 2 groups based on the PS question. The Japanese Orthopaedic Association (JOA) scores, and the Numeric Rating Scale (NRS) scores of low back pain (LBP), leg pain, and leg numbness were compared between the 2 groups preoperatively and at the latest visit. To identify the prognostic factors for dissatisfaction, multiple logistic regression analysis was performed. Results: Overall satisfaction rate was 75%. The JOA recovery rate, NRS improvement, and Short Form–8 (SF-8) were significantly higher in the satisfied group. Postoperative NRS scores of LBP, leg pain, and leg numbness were significantly lower in the satisfied group. Multivariate logistic regression analysis showed that smoking and scoliosis were significant risk factors for dissatisfaction. Conclusions: Overall satisfaction rate was 75% in patients with LSS undergoing decompression surgery. This study found that smoking status and scoliosis were associated with patient dissatisfaction following decompression in LSS patients.

scholarly journals Comparison of Enoxaparin and Warfarin for Secondary Prevention of Cancer-Associated Stroke

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Hyemin Jang ◽  
Jung Jae Lee ◽  
Mi Ji Lee ◽  
Sookyung Ryoo ◽  
Chang Hyo Yoon ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Secondary Prevention ◽  
Logistic Regression Analysis ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Patients With Cancer ◽  
Prevention Of Cancer ◽  
D Dimer

Background. The aim of this study was to determine which anticoagulant is superior for secondary prevention of cancer-associated stroke, using changes in D-dimer levels as a biomarker for recurrent thromboembolic events.Methods. We conducted a retrospective, single center observational study including patients with cancer-associated stroke who were treated with either enoxaparin or warfarin. Blood samples for measuring the initial and follow-up D-dimer levels were collected at admission and a median of 8 days after admission, respectively. Multiple logistic regression analysis was conducted to evaluate the factors that influenced D-dimer levels after treatment.Results. Although the initial D-dimer levels did not differ between the two groups, the follow-up levels were dramatically decreased in patients treated with enoxaparin, while they did not change with use of warfarin (3.88 μg/mL versus 17.42 μg/mL,p=0.026). On multiple logistic regression analysis, use of warfarin (OR 12.95;p=0.001) and the presence of systemic metastasis (OR 18.73;p=0.017) were independently associated with elevated D-dimer levels (≥10 μg/mL) after treatment.Conclusion. In cancer-associated stroke patients, treatment with enoxaparin may be more effective than treatment with warfarin for lowering the D-dimer levels. Future prospective studies are warranted to show that enoxaparin is better than warfarin for secondary prevention in cancer-associated stroke.

scholarly journals Irreversibility of Nerve Root Sedimentation Sign in Lumbar Spinal Stenosis After Decompression Surgery: Incidence and Risk Factors

2020 ◽  
Author(s):  
Jinhong Zhang ◽  
Qunhu Zhang ◽  
Shaoxiang Xia ◽  
Yunshan Xu ◽  
Jinrong Ni ◽  
...  
Keyword(s):  
Risk Factor ◽  
Clinical Outcomes ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Nerve Root ◽  
Multiple Logistic Regression Analysis ◽  
Decompression Surgery ◽  
Large Sample Size ◽  
Lumbar Spinal

Abstract Background. The nerve root sedimentation sign (Sed-sign) is a new diagnostic test for lumbar spinal stenosis. However, few studies have evaluated radiographical outcomes of positive Sed-sign after decompression surgery. The current study aims to evaluate the radiographicaland clinical outcomes of Sed-signafter decompression surgery among a relatively large sample sizeMethods. Patients with positive Sed-sign who underwent transforaminal lumbar interbody fusion (TLIF) surgery were reviewed. Based on postoperative MRI scans, patients with negative or irreversible Sed-sign were assigned to the reversible (R) or irreversible (Ir) groups, respectively. Demographics, radiographic parameters, and health-related quality of life (HRQOL) were evaluated.Results. The R and Ir groups were comprised of 67 and 15 patients, respectively. There were no significant differences between two groups in terms of mean age, sex, postoperative complications as well as mean follow-up time (all P>0.05). After surgery, disc height (DH), foramina height (FH), and segmental lordosis (SL) in both groups were restored. At the latest follow-up, the smallest cross-sectional area (CSA) was significantly increased when compared with preoperatively (P<0.05). The CSA value and correction rate in the R-group was considerably higher than in the Ir-group (P=0.002 and P=0.007). Both groups had improved HRQOL after TLIF surgery; however, the Oswestry disability index, Zürich Claudication Questionnaire, and visual analog scale for back and leg pain were higher in the Ir vs. R groups (P<0.05). Multiple logistic regression analysis revealed that a postoperative CSA less than 131.4 mm2 was a risk factor for the irreversibility of Sed-sign.Conclusion.TLIF surgery resulted in reversibility of positive Sed-sign for most patients. The irreversibility of Sed-sign was associated with poor clinical outcomes. Independent risk factor for the irreversibility of Sed-sign was CSA less than 131.4 mm2.

scholarly journals A long-term (4- to 12-year) follow-up study of surgical treatment of lumbar spinal stenosis

2000 ◽  
Vol 9 (6) ◽  
pp. 563-570 ◽  
Author(s):  
M. Cornefjord ◽  
G. Byröd ◽  
H. Brisby ◽  
B. Rydevik
Keyword(s):  
Surgical Treatment ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Follow Up Study ◽  
Lumbar Spinal
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