Surgery for Lumbar Spinal Stenosis in Patients With Mild Leg Pain Levels Is Associated With Unsatisfactory Outcome
2021 (English)In: Global Spine Journal, ISSN 2192-5682, E-ISSN 2192-5690, Vol. 11, no 8, p. 1202-1207Article in journal (Refereed) Published
Abstract [en]
Study Design: Prospective register cohort study.
Objectives: The indication for surgery in patients with lumbar spinal stenosis (LSS) is considered to be leg pain and neurogenic claudication (NC). Nevertheless, a significant part of patients operated for LSS have mild leg pain levels defined as leg pain <= minimally important clinical difference (MICD). Information is lacking on how to inform these patients about the probable outcome of surgery. The objective was to report the outcome of surgery for LSS in patients with a mild preoperative level of leg pain.
Methods: A total of 2559 patients operated upon for LSS with preoperative leg pain <= 3 NRS (Numerical Rating Scale) were evaluated for outcome at the 1-year follow-up. NRS for back pain, the Oswestry Disability Index (ODI), and the EuroQol (EQ-5D) were used.
Results: In the period 2007 to 2017, we identified 3239 patients (14%) who had mild leg pain (<= 3 on the NRS). In this cohort, leg pain increased 0.40 (0.56-0.37) and back pain decreased 1.0 (0.95-1.2) at the 1-year follow up. ODI decreased 11.1 (10.2-11.4) and the EQ-5D increased 0.15 (0.17-0.14). A total of 31% reached successful outcome in terms of back pain, 43% in terms of ODI and 48% in terms of EQ-5D. 63% of the patients were satisfied with the outcome.
Conclusion: A minority of patients with mild leg pain levels operated upon for LSS attain MICD for back pain, ODI, and EQ-5D. The results from this study can aid the surgeon in the shared decision-making process before surgery.
Place, publisher, year, edition, pages
Sage Publications, 2021. Vol. 11, no 8, p. 1202-1207
Keywords [en]
lumbar, stenosis, spondyliosthesis, low back pain, leg pain, outcome, spinal stenosis
National Category
Neurology Orthopaedics
Identifiers
URN: urn:nbn:se:oru:diva-85184DOI: 10.1177/2192568220942510ISI: 000558289700001PubMedID: 32748656Scopus ID: 2-s2.0-85088963232OAI: oai:DiVA.org:oru-85184DiVA, id: diva2:1462716
2020-08-312020-08-312021-10-21Bibliographically approved