- Title
- Short- and long-term outcome of microscopic lumbar spine surgery in patients with predominant back or predominant leg pain
- Creator
- Stienen, Martin N.; Joswig, Holger; Smoll, Nicolas R.; Corniola, Marco V.; Schaller, Karl; Hildebrandt, Gerhard; Gautschi, Oliver P.
- Relation
- World Neurosurgery Vol. 93, p. 458-465.E1
- Publisher Link
- http://dx.doi.org/10.1016/j.wneu.2016.06.120
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2016
- Description
- Objective: This study assessed whether predominant back pain (pBP) represents a negative outcome predictor in patients undergoing microscopic spine surgery without fusion for a lumbar disc herniation (LDH) or spinal stenosis (LSS). Methods: Retrospective analysis of prospectively collected data on consecutive patients with LDH or LSS at 2 centers. Patients with visual analog scale (VAS) back pain ≥VAS leg pain were assigned to the pBP group, and compared with patients with predominant VAS leg pain (pLP). Outcome measures included the Roland-Morris Disability Index (RMDI), Oswestry Disability Index (ODI), health-related quality of life measures, Short-Form (SF)-12 Physical Component Summary (PCS), and EuroQol (EQ-5D) index at 3 days, 6 weeks (W6), 6 months, and 1 year postoperatively. Results: A total of 325 patients (154 [47.4%] with pBP and 171 [52.6%] with pLP) were included. Patients with pBP were about 6 years older and more often had LSS. There was no significant difference between the group means of the RMDI, ODI, SF-12 PCS, or EQ-5D at any postoperative time point. The most improvement was observed until the W6 follow-up with little or no improvement thereafter up to 1 year postoperatively. Patients with pBP were as likely as patients with pLP to be W6 responders on the RMDI (odds ratio [OR], 0.91; 95% confidence interval [CI], 0.38–2.16; P = 0.831), ODI (OR, 1.00; 95% CI 0.52–1.92; P = 0.996), SF-12 PCS (OR, 1.09; 95% CI 0.58–2.04; P = 0.791), and EQ-5D (OR, 0.62; 95% CI 0.32–1.21; P = 0.164). Disease-specific subgroup analyses confirmed the results. Conclusions: The present data suggest that patients with pBP have comparable functional and health-related quality of life outcomes after surgery for LDH or LSS with those of patients with pLP.
- Subject
- back pain; degenerative disc disease; dominant symptom; health-related quality of life; leg pain; low back pain; lumbar spine surgery
- Identifier
- http://hdl.handle.net/1959.13/1345721
- Identifier
- uon:29712
- Identifier
- ISSN:1878-8750
- Language
- eng
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