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Enduring improvement in Oswestry Disability Index outcomes following lumbar microscopic interlaminar decompression: An appraisal of prospectively collected patient outcomes.

Khan MB, Bashir MU, Kumar R, Enam SA - J Craniovertebr Junction Spine (2015 Oct-Dec)

Bottom Line: At the 2 years follow-up assessment, 3.3% (n = 2) patients who had earlier not achieved MCID did so, 78.3% (n = 47) of patients were found to have a change in ODI score of <10 or no change, while 18.3% (n = 11) reported a deterioration in their ODI scores.The duration of symptoms prior to surgery was found to predict the change in ODI at 2 years follow-up (P = 0.04).Preoperative ODI scores and duration of symptoms prior to surgery can predict postoperative outcomes.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Section of Neurosurgery, Aga Khan University Hospital, Karachi, Sindh, Pakistan.

ABSTRACT

Objectives: Our present study aims to assess the short and long-term postoperative outcome of microscopic interlaminar decompression from a neurosurgical center in a developing country and also aims to further determine any predictors of functional outcome.

Materials and methods: All patients with moderate to severe symptomatic stenosis undergoing elective posterior lumbar spinal decompression were prospectively enrolled in a database. Preoperative, 2 weeks and 2 years postoperative Oswestry Disability Index (ODI) scores were determined for all patients. These scores were retrospectively compared using repeated measures analysis of variance. Further, linear regression modelling was applied to determine the effect of preoperative ODI, body mass index, age, prior physiotherapy, duration of symptoms, and single or multiple level decompression on the change in ODI at 2 weeks and 2 years follow-up respectively.

Results: A total of 60 consecutive patients (40 males, 20 females) were included for statistical analysis. The percentage of patients with a minimum clinically important difference (MCID), using an ODI threshold value of 10, was 86.7% (n = 52) at the 2 weeks postoperative follow-up. At the 2 years follow-up assessment, 3.3% (n = 2) patients who had earlier not achieved MCID did so, 78.3% (n = 47) of patients were found to have a change in ODI score of <10 or no change, while 18.3% (n = 11) reported a deterioration in their ODI scores. The preoperative ODI score was an independent predictor of change in ODI score at 2 weeks and 2 years respectively (P < 0.0005). The duration of symptoms prior to surgery was found to predict the change in ODI at 2 years follow-up (P = 0.04).

Conclusion: The evidence regarding the long-term and short-term efficacy of microscopic interlaminar decompression in symptomatic lumbar stenosis is overwhelming. Preoperative ODI scores and duration of symptoms prior to surgery can predict postoperative outcomes.

No MeSH data available.


Related in: MedlinePlus

Scatter plot showing correlation between change in Oswestry Disability Index scores at 2 years with duration of symptoms prior to surgery
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Figure 4: Scatter plot showing correlation between change in Oswestry Disability Index scores at 2 years with duration of symptoms prior to surgery

Mentions: Linear regression analysis showed that the preoperative ODI score was an independent predictor of change in ODI score at 2 weeks and 2 years respectively (P < 0.0005); patients with worse preoperative ODI scores achieved greater ODI postoperative improvement with a regression coefficient of 0.81. Preoperative BMI, age, comorbids, duration of symptoms, physiotherapy and extent of decompression (single vs. multiple) were not significant predictors of change in ODI at either the 2 weeks or 2 years follow-up. Interestingly, the duration of symptoms prior to surgery was found to predict the change in ODI at 2 years follow-up after having adjusted for all other variables (P = 0.04); patients with a greater duration of symptoms prior to surgery had a smaller change in ODI with a regression coefficient of −0.20 [Figure 4 and Table 2].


Enduring improvement in Oswestry Disability Index outcomes following lumbar microscopic interlaminar decompression: An appraisal of prospectively collected patient outcomes.

Khan MB, Bashir MU, Kumar R, Enam SA - J Craniovertebr Junction Spine (2015 Oct-Dec)

Scatter plot showing correlation between change in Oswestry Disability Index scores at 2 years with duration of symptoms prior to surgery
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4660497&req=5

Figure 4: Scatter plot showing correlation between change in Oswestry Disability Index scores at 2 years with duration of symptoms prior to surgery
Mentions: Linear regression analysis showed that the preoperative ODI score was an independent predictor of change in ODI score at 2 weeks and 2 years respectively (P < 0.0005); patients with worse preoperative ODI scores achieved greater ODI postoperative improvement with a regression coefficient of 0.81. Preoperative BMI, age, comorbids, duration of symptoms, physiotherapy and extent of decompression (single vs. multiple) were not significant predictors of change in ODI at either the 2 weeks or 2 years follow-up. Interestingly, the duration of symptoms prior to surgery was found to predict the change in ODI at 2 years follow-up after having adjusted for all other variables (P = 0.04); patients with a greater duration of symptoms prior to surgery had a smaller change in ODI with a regression coefficient of −0.20 [Figure 4 and Table 2].

Bottom Line: At the 2 years follow-up assessment, 3.3% (n = 2) patients who had earlier not achieved MCID did so, 78.3% (n = 47) of patients were found to have a change in ODI score of <10 or no change, while 18.3% (n = 11) reported a deterioration in their ODI scores.The duration of symptoms prior to surgery was found to predict the change in ODI at 2 years follow-up (P = 0.04).Preoperative ODI scores and duration of symptoms prior to surgery can predict postoperative outcomes.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Section of Neurosurgery, Aga Khan University Hospital, Karachi, Sindh, Pakistan.

ABSTRACT

Objectives: Our present study aims to assess the short and long-term postoperative outcome of microscopic interlaminar decompression from a neurosurgical center in a developing country and also aims to further determine any predictors of functional outcome.

Materials and methods: All patients with moderate to severe symptomatic stenosis undergoing elective posterior lumbar spinal decompression were prospectively enrolled in a database. Preoperative, 2 weeks and 2 years postoperative Oswestry Disability Index (ODI) scores were determined for all patients. These scores were retrospectively compared using repeated measures analysis of variance. Further, linear regression modelling was applied to determine the effect of preoperative ODI, body mass index, age, prior physiotherapy, duration of symptoms, and single or multiple level decompression on the change in ODI at 2 weeks and 2 years follow-up respectively.

Results: A total of 60 consecutive patients (40 males, 20 females) were included for statistical analysis. The percentage of patients with a minimum clinically important difference (MCID), using an ODI threshold value of 10, was 86.7% (n = 52) at the 2 weeks postoperative follow-up. At the 2 years follow-up assessment, 3.3% (n = 2) patients who had earlier not achieved MCID did so, 78.3% (n = 47) of patients were found to have a change in ODI score of <10 or no change, while 18.3% (n = 11) reported a deterioration in their ODI scores. The preoperative ODI score was an independent predictor of change in ODI score at 2 weeks and 2 years respectively (P < 0.0005). The duration of symptoms prior to surgery was found to predict the change in ODI at 2 years follow-up (P = 0.04).

Conclusion: The evidence regarding the long-term and short-term efficacy of microscopic interlaminar decompression in symptomatic lumbar stenosis is overwhelming. Preoperative ODI scores and duration of symptoms prior to surgery can predict postoperative outcomes.

No MeSH data available.


Related in: MedlinePlus