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The impact of incidental durotomy on the outcome of decompression surgery in degenerative lumbar spinal canal stenosis: analysis of the Lumbar Spinal Outcome Study (LSOS) data--a Swiss prospective multi-center cohort study.

Ulrich NH, Burgstaller JM, Brunner F, Porchet F, Farshad M, Pichierri G, Steurer J, Held U, LSOS Study Gro - BMC Musculoskelet Disord (2016)

Bottom Line: All patients improved over time.None of the between-group differences were statistically significant.However, only 15 patients were included in the durotomy group but these findings remained even after adjusting for observed differences in baseline characteristics.

View Article: PubMed Central - PubMed

Affiliation: Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Pestalozzistr. 24, 8091, Zürich, Switzerland. nils.hb.ulrich@gmail.com.

ABSTRACT

Background: Incidental durotomy is a well-known complication during surgery for degenerative lumbar spinal stenosis (DLSS). In this prospective multicenter cohort study including eight medical centers our aim was to assess whether incidental durotomy during first-time lumbar spinal stenosis decompression surgery without fusion has an impact on long-term outcome.

Methods: Patients of the multi-center Lumbar Stenosis Outcome Study (LSOS) with confirmed DLSS undergoing first-time decompression without fusion were enrolled in this study. Baseline patient characteristics and outcomes were analyzed at 6, 12, and 24 months follow-up respectively with the Spinal Stenosis Measure (SSM), the Numeric Rating Scale (NRS), Feeling Thermometer (FT), the EQ-5D-EL, and the Roland and Morris Disability Questionnaire (RMDQ).

Results: A total of 167 patients met the inclusion criteria. Fifteen (9%) of those patients had an incidental durotomy. Baseline characteristics were similar between the durotomy and no-durotomy group. All patients improved over time. In the group of durotomy patients, the median improvement in SSM symptoms scale was 1.1 points at 6 months, 1.1 points at 12 months, and 1.6 points at 24 months after baseline. For the no-durotomy group, these improvements were 0.8, 0.9, and 0.9. For SSM function the improvements were 1.0, 0.8, and 0.9 in the durotomy group, and 0.6, 0.8, and 0.8 in the no-durotomy group. None of the between-group differences were statistically significant.

Conclusions: Incidental durotomy in patients with DLSS undergoing first-time decompression surgery without fusion did not have negative effect on long-term outcome and quality of life. However, only 15 patients were included in the durotomy group but these findings remained even after adjusting for observed differences in baseline characteristics.

No MeSH data available.


Related in: MedlinePlus

SSM symptoms and function and EQ-5D-EL at baseline, 6, 12, and 24 months (durotomy/no-durotomy group)
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Fig1: SSM symptoms and function and EQ-5D-EL at baseline, 6, 12, and 24 months (durotomy/no-durotomy group)

Mentions: Figure 1 shows SSM symptoms and function, EQ-5D-EL sum score and actual health status over time with boxplots.Fig. 1


The impact of incidental durotomy on the outcome of decompression surgery in degenerative lumbar spinal canal stenosis: analysis of the Lumbar Spinal Outcome Study (LSOS) data--a Swiss prospective multi-center cohort study.

Ulrich NH, Burgstaller JM, Brunner F, Porchet F, Farshad M, Pichierri G, Steurer J, Held U, LSOS Study Gro - BMC Musculoskelet Disord (2016)

SSM symptoms and function and EQ-5D-EL at baseline, 6, 12, and 24 months (durotomy/no-durotomy group)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4835881&req=5

Fig1: SSM symptoms and function and EQ-5D-EL at baseline, 6, 12, and 24 months (durotomy/no-durotomy group)
Mentions: Figure 1 shows SSM symptoms and function, EQ-5D-EL sum score and actual health status over time with boxplots.Fig. 1

Bottom Line: All patients improved over time.None of the between-group differences were statistically significant.However, only 15 patients were included in the durotomy group but these findings remained even after adjusting for observed differences in baseline characteristics.

View Article: PubMed Central - PubMed

Affiliation: Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Pestalozzistr. 24, 8091, Zürich, Switzerland. nils.hb.ulrich@gmail.com.

ABSTRACT

Background: Incidental durotomy is a well-known complication during surgery for degenerative lumbar spinal stenosis (DLSS). In this prospective multicenter cohort study including eight medical centers our aim was to assess whether incidental durotomy during first-time lumbar spinal stenosis decompression surgery without fusion has an impact on long-term outcome.

Methods: Patients of the multi-center Lumbar Stenosis Outcome Study (LSOS) with confirmed DLSS undergoing first-time decompression without fusion were enrolled in this study. Baseline patient characteristics and outcomes were analyzed at 6, 12, and 24 months follow-up respectively with the Spinal Stenosis Measure (SSM), the Numeric Rating Scale (NRS), Feeling Thermometer (FT), the EQ-5D-EL, and the Roland and Morris Disability Questionnaire (RMDQ).

Results: A total of 167 patients met the inclusion criteria. Fifteen (9%) of those patients had an incidental durotomy. Baseline characteristics were similar between the durotomy and no-durotomy group. All patients improved over time. In the group of durotomy patients, the median improvement in SSM symptoms scale was 1.1 points at 6 months, 1.1 points at 12 months, and 1.6 points at 24 months after baseline. For the no-durotomy group, these improvements were 0.8, 0.9, and 0.9. For SSM function the improvements were 1.0, 0.8, and 0.9 in the durotomy group, and 0.6, 0.8, and 0.8 in the no-durotomy group. None of the between-group differences were statistically significant.

Conclusions: Incidental durotomy in patients with DLSS undergoing first-time decompression surgery without fusion did not have negative effect on long-term outcome and quality of life. However, only 15 patients were included in the durotomy group but these findings remained even after adjusting for observed differences in baseline characteristics.

No MeSH data available.


Related in: MedlinePlus