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Resting Pain Level as a Preoperative Predictor of Success With Indirect Decompression for Lumbar Spinal Stenosis: A Pilot Study

STUDY DESIGN: Retrospective review of a single institution. OBJECTIVE: To determine if resting leg pain level is a predictor of success for indirect decompression in the setting of lumbar spinal stenosis, with lower levels of rest pain correlating with greater likelihood of successful indirect decom...

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Autores principales: Khalsa, Amrit S., Eghbali, Areian, Eastlack, Robert K., Tran, Stacie, Akbarnia, Behrooz A., Ledesma, Justin B., Mundis, Gregory M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6448191/
https://www.ncbi.nlm.nih.gov/pubmed/30984493
http://dx.doi.org/10.1177/2192568218765986
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author Khalsa, Amrit S.
Eghbali, Areian
Eastlack, Robert K.
Tran, Stacie
Akbarnia, Behrooz A.
Ledesma, Justin B.
Mundis, Gregory M.
author_facet Khalsa, Amrit S.
Eghbali, Areian
Eastlack, Robert K.
Tran, Stacie
Akbarnia, Behrooz A.
Ledesma, Justin B.
Mundis, Gregory M.
author_sort Khalsa, Amrit S.
collection PubMed
description STUDY DESIGN: Retrospective review of a single institution. OBJECTIVE: To determine if resting leg pain level is a predictor of success for indirect decompression in the setting of lumbar spinal stenosis, with lower levels of rest pain correlating with greater likelihood of successful indirect decompression. METHODS: Reviewed anterior or lateral lumbar interbody fusions from T12 to L5-S1 patients with a posterior-based pedicle screw-rod construct. Patients were separated into 2 groups based on a preoperative response to Oswestry Disability Index (ODI) Question 7 regarding level of pain at rest in the supine position. Responses of 0 to 2 (minimal rest pain) were group 1 (n = 54) and responses of 3 to 5 (significant rest pain) were group 2 (n = 16). RESULTS: Preoperative difference was detected between groups 1 and 2, in ODI (38 vs 63, P < .001) and Numeric Rating Scale (NRS) back (6.8 vs 7.9, P = .023). Three-month NRS leg and back scores were significantly lower in group 1 (leg, 1.9 vs 4.8, P < .001; back, 3.5 vs 6.4, P = .001). A significant difference was further noted in the percentage decrease in NRS leg and back scores from pre- to 3 months postoperatively between groups 1 and 2 (leg, 68.4% vs 22.7%, P < .001; back, 40.0% vs 7.4%, P = .012). Group 1 reached minimal clinically important difference for leg pain more often than group 2 (83.3% vs 43.8%, P = .001). CONCLUSION: Preoperative assessment of rest pain level in the supine position has a significant association with reduction in NRS leg and back scores in patients undergoing indirect decompression for lumbar spinal stenosis. This tool may successfully indicate which patients will be candidates for indirect decompression with interbody fusion from an anterior or lateral approach.
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spelling pubmed-64481912019-04-12 Resting Pain Level as a Preoperative Predictor of Success With Indirect Decompression for Lumbar Spinal Stenosis: A Pilot Study Khalsa, Amrit S. Eghbali, Areian Eastlack, Robert K. Tran, Stacie Akbarnia, Behrooz A. Ledesma, Justin B. Mundis, Gregory M. Global Spine J Original Articles STUDY DESIGN: Retrospective review of a single institution. OBJECTIVE: To determine if resting leg pain level is a predictor of success for indirect decompression in the setting of lumbar spinal stenosis, with lower levels of rest pain correlating with greater likelihood of successful indirect decompression. METHODS: Reviewed anterior or lateral lumbar interbody fusions from T12 to L5-S1 patients with a posterior-based pedicle screw-rod construct. Patients were separated into 2 groups based on a preoperative response to Oswestry Disability Index (ODI) Question 7 regarding level of pain at rest in the supine position. Responses of 0 to 2 (minimal rest pain) were group 1 (n = 54) and responses of 3 to 5 (significant rest pain) were group 2 (n = 16). RESULTS: Preoperative difference was detected between groups 1 and 2, in ODI (38 vs 63, P < .001) and Numeric Rating Scale (NRS) back (6.8 vs 7.9, P = .023). Three-month NRS leg and back scores were significantly lower in group 1 (leg, 1.9 vs 4.8, P < .001; back, 3.5 vs 6.4, P = .001). A significant difference was further noted in the percentage decrease in NRS leg and back scores from pre- to 3 months postoperatively between groups 1 and 2 (leg, 68.4% vs 22.7%, P < .001; back, 40.0% vs 7.4%, P = .012). Group 1 reached minimal clinically important difference for leg pain more often than group 2 (83.3% vs 43.8%, P = .001). CONCLUSION: Preoperative assessment of rest pain level in the supine position has a significant association with reduction in NRS leg and back scores in patients undergoing indirect decompression for lumbar spinal stenosis. This tool may successfully indicate which patients will be candidates for indirect decompression with interbody fusion from an anterior or lateral approach. SAGE Publications 2018-07-26 2019-04 /pmc/articles/PMC6448191/ /pubmed/30984493 http://dx.doi.org/10.1177/2192568218765986 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
Khalsa, Amrit S.
Eghbali, Areian
Eastlack, Robert K.
Tran, Stacie
Akbarnia, Behrooz A.
Ledesma, Justin B.
Mundis, Gregory M.
Resting Pain Level as a Preoperative Predictor of Success With Indirect Decompression for Lumbar Spinal Stenosis: A Pilot Study
title Resting Pain Level as a Preoperative Predictor of Success With Indirect Decompression for Lumbar Spinal Stenosis: A Pilot Study
title_full Resting Pain Level as a Preoperative Predictor of Success With Indirect Decompression for Lumbar Spinal Stenosis: A Pilot Study
title_fullStr Resting Pain Level as a Preoperative Predictor of Success With Indirect Decompression for Lumbar Spinal Stenosis: A Pilot Study
title_full_unstemmed Resting Pain Level as a Preoperative Predictor of Success With Indirect Decompression for Lumbar Spinal Stenosis: A Pilot Study
title_short Resting Pain Level as a Preoperative Predictor of Success With Indirect Decompression for Lumbar Spinal Stenosis: A Pilot Study
title_sort resting pain level as a preoperative predictor of success with indirect decompression for lumbar spinal stenosis: a pilot study
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6448191/
https://www.ncbi.nlm.nih.gov/pubmed/30984493
http://dx.doi.org/10.1177/2192568218765986
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