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The Duration of Symptoms Does Not Impact Clinical Outcomes Following Lumbar Decompression Surgery.

Abstract：

STUDY DESIGN:A retrospective cohort analysis. OBJECTIVE:The aim of this study was to assess whether duration of symptoms (DOS) has an effect on clinical outcomes in patients undergoing lumbar decompression. SUMMARY OF BACKGROUND DATA:The success of surgical interventions for lumbar spinal stenosis varies depending on numerous factors, including DOS. However, existing literature does not provide a clear indication of the outcome of lumbar decompression surgery in regard to DOS secondary to nerve root compression. METHODS:Analysis of patients who underwent primary lumbar laminectomy from 2008 through 2015 by one of two senior orthopedic spine surgeons was conducted. Exclusion criteria were as follows: previous lumbar surgery, patient under 18 years of age at time of surgery, or postoperative follow-up less than 3 months. Patients were divided into groups on the basis of preoperative DOS: less than 1 year and 1 year or greater. Patient-reported outcomes were obtained using Oswestry Disability Index (ODI) scores, Visual Analog Scales (VAS) scores for the back and leg, 12-Item Short Form Mental and Physical Survey (SF-12) scores, and Veterans Rand 12-Item Health Mental and Physical Survey (VR-12) scores. Patients were surveyed about expectations and postoperative satisfaction. RESULTS:Two hundred ten patients were assessed; 108 with DOS of less than 1 year and 102 with DOS of 1 year or more. On multivariate analysis, patients with DOS of 1 year or greater presented with significantly lower SF-12 scores (P = 0.043). No significant differences existed in other outcome survey scores. Reoperation rates were not significantly different (P = 0.904). Both groups reported high levels of satisfaction (odds ratio 0.42, P = 0.483) and that surgery met or exceeded their expectations (odds ratio 1.00, P = 0.308). CONCLUSION:Symptom chronicity did not significantly affect postoperative clinical outcomes, reoperation rates, or patient satisfaction. Nonoperative treatment of lumbar spinal stenosis is often successful but may delay operative intervention. However, results of this study suggest that the delay does not negatively impact surgical outcomes. LEVEL OF EVIDENCE:3.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Movassaghi K,Basques BA,Louie PK,Khan JM,Derman PB,Nolte MT,Paul JC,Goldberg EJ,An HS

doi

10.1097/BRS.0000000000002818

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

305-308

issue

eissn

0362-2436

issn

1528-1159

pii

00007632-201903010-00004

journal_volume

pub_type

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The Duration of Symptoms Does Not Impact Clinical Outcomes Following Lumbar Decompression Surgery.