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Predictors of Reoperation after Microdecompression in Lumbar Spinal Stenosis

OBJECTIVE: The risk factors of reoperation after microdecompression (MD) for lumbar spinal stenosis (LSS) are unclear. In this study, we presented the outcomes of MD for degenerative LSS and investigated the risk factors associated with reoperation. METHODS: A retrospective review was conducted usin...

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Autores principales: Hwang, Hee-Jong, Park, Hyung-Ki, Lee, Gwang-Soo, Heo, June-Young, Chang, Jae-Chil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Spinal Neurosurgery Society 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5266098/
https://www.ncbi.nlm.nih.gov/pubmed/28127375
http://dx.doi.org/10.14245/kjs.2016.13.4.183
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author Hwang, Hee-Jong
Park, Hyung-Ki
Lee, Gwang-Soo
Heo, June-Young
Chang, Jae-Chil
author_facet Hwang, Hee-Jong
Park, Hyung-Ki
Lee, Gwang-Soo
Heo, June-Young
Chang, Jae-Chil
author_sort Hwang, Hee-Jong
collection PubMed
description OBJECTIVE: The risk factors of reoperation after microdecompression (MD) for lumbar spinal stenosis (LSS) are unclear. In this study, we presented the outcomes of MD for degenerative LSS and investigated the risk factors associated with reoperation. METHODS: A retrospective review was conducted using the clinical records and radiographs of patients with LSS who underwent MD. For clinical evaluation, we used the Japanese Orthopedic Association (JOA) scoring system for low back pain, body mass index, and Charlson comorbidity index. For radiological evaluation, disc height, facet angle, and sagittal rotation angle were measured in operated segments. Also the Modic change and Pfirrmann grade for degeneration in the endplate and disc were scored. RESULTS: Forty-three patients aged 69±9 years at index surgery were followed for 48±25 months. The average preoperative JOA score was 6.9±1.6 points. The score improved to 9.1±2.1 points at the latest follow-up (p<0.001). Seven patients (16.3%) underwent reoperation. Clinical and radiological factors except operation level and Pfirrmann grade showed a p-value >0.1. Patients with Pfirrmann grade IV and lower lumbar segment had a 29.1% rate of reoperation (p=0.001), whereas patients without these factors had a 0% rate of reoperation. CONCLUSION: Moderate disk degeneration (Pfirrmann IV) in lower lumbar segments is a risk factor of disk herniation or foraminal stenosis requiring reoperation after MD in LSS.
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spelling pubmed-52660982017-01-26 Predictors of Reoperation after Microdecompression in Lumbar Spinal Stenosis Hwang, Hee-Jong Park, Hyung-Ki Lee, Gwang-Soo Heo, June-Young Chang, Jae-Chil Korean J Spine Clinical Article OBJECTIVE: The risk factors of reoperation after microdecompression (MD) for lumbar spinal stenosis (LSS) are unclear. In this study, we presented the outcomes of MD for degenerative LSS and investigated the risk factors associated with reoperation. METHODS: A retrospective review was conducted using the clinical records and radiographs of patients with LSS who underwent MD. For clinical evaluation, we used the Japanese Orthopedic Association (JOA) scoring system for low back pain, body mass index, and Charlson comorbidity index. For radiological evaluation, disc height, facet angle, and sagittal rotation angle were measured in operated segments. Also the Modic change and Pfirrmann grade for degeneration in the endplate and disc were scored. RESULTS: Forty-three patients aged 69±9 years at index surgery were followed for 48±25 months. The average preoperative JOA score was 6.9±1.6 points. The score improved to 9.1±2.1 points at the latest follow-up (p<0.001). Seven patients (16.3%) underwent reoperation. Clinical and radiological factors except operation level and Pfirrmann grade showed a p-value >0.1. Patients with Pfirrmann grade IV and lower lumbar segment had a 29.1% rate of reoperation (p=0.001), whereas patients without these factors had a 0% rate of reoperation. CONCLUSION: Moderate disk degeneration (Pfirrmann IV) in lower lumbar segments is a risk factor of disk herniation or foraminal stenosis requiring reoperation after MD in LSS. The Korean Spinal Neurosurgery Society 2016-12 2016-12-31 /pmc/articles/PMC5266098/ /pubmed/28127375 http://dx.doi.org/10.14245/kjs.2016.13.4.183 Text en Copyright © 2016 The Korean Spinal Neurosurgery Society http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Article
Hwang, Hee-Jong
Park, Hyung-Ki
Lee, Gwang-Soo
Heo, June-Young
Chang, Jae-Chil
Predictors of Reoperation after Microdecompression in Lumbar Spinal Stenosis
title Predictors of Reoperation after Microdecompression in Lumbar Spinal Stenosis
title_full Predictors of Reoperation after Microdecompression in Lumbar Spinal Stenosis
title_fullStr Predictors of Reoperation after Microdecompression in Lumbar Spinal Stenosis
title_full_unstemmed Predictors of Reoperation after Microdecompression in Lumbar Spinal Stenosis
title_short Predictors of Reoperation after Microdecompression in Lumbar Spinal Stenosis
title_sort predictors of reoperation after microdecompression in lumbar spinal stenosis
topic Clinical Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5266098/
https://www.ncbi.nlm.nih.gov/pubmed/28127375
http://dx.doi.org/10.14245/kjs.2016.13.4.183
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