Clinical outcome after surgery for lumbar spinal stenosis in patients with insignificant lower extremity pain. A prospective cohort study from the Norwegian registry for spine surgery
Abstract Background Spinal stenosis is a clinical diagnosis in which the main symptom is pain radiating to the lower extremities, or neurogenic claudication. Radiological spinal stenosis is commonly observed in the population and it is debated whether patients with no lower extremity pain should be...
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doaj-af102f993cea46e683f5d2fad7c885c22020-11-24T21:40:55ZengBMCBMC Musculoskeletal Disorders1471-24742019-01-012011810.1186/s12891-019-2407-5Clinical outcome after surgery for lumbar spinal stenosis in patients with insignificant lower extremity pain. A prospective cohort study from the Norwegian registry for spine surgeryErland Hermansen0Tor Åge Myklebust1Ivar Magne Austevoll2Frode Rekeland3Tore Solberg4Kjersti Storheim5Oliver Grundnes6Jørn Aaen7Jens Ivar Brox8Christian Hellum9Kari Indrekvam10Department of Orthopedic Surgery, Ålesund Hospital, Møre and Romsdal Hospital TrustDepartment of Research, Møre og Romsdal Hospital TrustKysthospitalet in Hagevik, Orthopedic Clinic, Haukeland University HospitalKysthospitalet in Hagevik, Orthopedic Clinic, Haukeland University HospitalDepartment of Neurosurgery, University Hospital of Northern NorwayCommunication and Research Unit for Musculoskeletal Disorders (FORMI), Oslo University Hospital and University of OsloDepartment of Orthopedics, Akershus University HospitalDepartment of Orthopedic Surgery, Ålesund Hospital, Møre and Romsdal Hospital TrustDepartment of Physical Medicine and Rehabilitation, University of OsloDepartment of Orthopedics, Oslo University HospitalKysthospitalet in Hagevik, Orthopedic Clinic, Haukeland University HospitalAbstract Background Spinal stenosis is a clinical diagnosis in which the main symptom is pain radiating to the lower extremities, or neurogenic claudication. Radiological spinal stenosis is commonly observed in the population and it is debated whether patients with no lower extremity pain should be labelled as having spinal stenosis. However, these patients is found in the Norwegian Registry for Spine Surgery, the main object of the present study was to compare the clinical outcomes after decompressive surgery in patients with insignificant lower extremity pain, with those with more severe pain. Methods This study is based on data from the Norwegian Registry for Spine Surgery (NORspine). Patients who had decompressive surgery in the period from 7/1–2007 to 11/3–2013 at 31 hospitals were included. The patients was divided into four groups based on preoperative Numeric Rating Scale (NRS)-score for lower extremity pain. Patients in group 1 had insignificant pain, group 2 had mild or moderate pain, group 3 severe pain and group 4 extremely severe pain. The primary outcome was change in the Oswestry Disability Index (ODI). Successfully treated patients were defined as patients reporting at least 30% reduction of baseline ODI, and the number of successfully treated patients in each group were recorded. Results In total, 3181 patients were eligible; 154 patients in group 1; 753 in group 2; 1766 in group 3; and 528 in group 4. Group 1 had significantly less improvement from baseline in all the clinical scores 12 months after surgery compared to the other groups. However, with a mean reduction of 8 ODI points and 56% of patients showing a reduction of at least 30% in their ODI score, the proportion of patients defined as successfully treated in group 1, was not significantly different from that of other groups. Conclusion This national register study shows that patients with insignificant lower extremity pain had less improvement in primary and secondary outcome parameters from baseline to follow-up compared to patients with more severe lower extremity pain.http://link.springer.com/article/10.1186/s12891-019-2407-5Lumbar spinal stenosisLower extremity painRegister trialClinical outcome |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Erland Hermansen Tor Åge Myklebust Ivar Magne Austevoll Frode Rekeland Tore Solberg Kjersti Storheim Oliver Grundnes Jørn Aaen Jens Ivar Brox Christian Hellum Kari Indrekvam |
spellingShingle |
Erland Hermansen Tor Åge Myklebust Ivar Magne Austevoll Frode Rekeland Tore Solberg Kjersti Storheim Oliver Grundnes Jørn Aaen Jens Ivar Brox Christian Hellum Kari Indrekvam Clinical outcome after surgery for lumbar spinal stenosis in patients with insignificant lower extremity pain. A prospective cohort study from the Norwegian registry for spine surgery BMC Musculoskeletal Disorders Lumbar spinal stenosis Lower extremity pain Register trial Clinical outcome |
author_facet |
Erland Hermansen Tor Åge Myklebust Ivar Magne Austevoll Frode Rekeland Tore Solberg Kjersti Storheim Oliver Grundnes Jørn Aaen Jens Ivar Brox Christian Hellum Kari Indrekvam |
author_sort |
Erland Hermansen |
title |
Clinical outcome after surgery for lumbar spinal stenosis in patients with insignificant lower extremity pain. A prospective cohort study from the Norwegian registry for spine surgery |
title_short |
Clinical outcome after surgery for lumbar spinal stenosis in patients with insignificant lower extremity pain. A prospective cohort study from the Norwegian registry for spine surgery |
title_full |
Clinical outcome after surgery for lumbar spinal stenosis in patients with insignificant lower extremity pain. A prospective cohort study from the Norwegian registry for spine surgery |
title_fullStr |
Clinical outcome after surgery for lumbar spinal stenosis in patients with insignificant lower extremity pain. A prospective cohort study from the Norwegian registry for spine surgery |
title_full_unstemmed |
Clinical outcome after surgery for lumbar spinal stenosis in patients with insignificant lower extremity pain. A prospective cohort study from the Norwegian registry for spine surgery |
title_sort |
clinical outcome after surgery for lumbar spinal stenosis in patients with insignificant lower extremity pain. a prospective cohort study from the norwegian registry for spine surgery |
publisher |
BMC |
series |
BMC Musculoskeletal Disorders |
issn |
1471-2474 |
publishDate |
2019-01-01 |
description |
Abstract Background Spinal stenosis is a clinical diagnosis in which the main symptom is pain radiating to the lower extremities, or neurogenic claudication. Radiological spinal stenosis is commonly observed in the population and it is debated whether patients with no lower extremity pain should be labelled as having spinal stenosis. However, these patients is found in the Norwegian Registry for Spine Surgery, the main object of the present study was to compare the clinical outcomes after decompressive surgery in patients with insignificant lower extremity pain, with those with more severe pain. Methods This study is based on data from the Norwegian Registry for Spine Surgery (NORspine). Patients who had decompressive surgery in the period from 7/1–2007 to 11/3–2013 at 31 hospitals were included. The patients was divided into four groups based on preoperative Numeric Rating Scale (NRS)-score for lower extremity pain. Patients in group 1 had insignificant pain, group 2 had mild or moderate pain, group 3 severe pain and group 4 extremely severe pain. The primary outcome was change in the Oswestry Disability Index (ODI). Successfully treated patients were defined as patients reporting at least 30% reduction of baseline ODI, and the number of successfully treated patients in each group were recorded. Results In total, 3181 patients were eligible; 154 patients in group 1; 753 in group 2; 1766 in group 3; and 528 in group 4. Group 1 had significantly less improvement from baseline in all the clinical scores 12 months after surgery compared to the other groups. However, with a mean reduction of 8 ODI points and 56% of patients showing a reduction of at least 30% in their ODI score, the proportion of patients defined as successfully treated in group 1, was not significantly different from that of other groups. Conclusion This national register study shows that patients with insignificant lower extremity pain had less improvement in primary and secondary outcome parameters from baseline to follow-up compared to patients with more severe lower extremity pain. |
topic |
Lumbar spinal stenosis Lower extremity pain Register trial Clinical outcome |
url |
http://link.springer.com/article/10.1186/s12891-019-2407-5 |
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