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Published on: March 23, 2019
Predictors for failure after surgery for lumbar spinal stenosis: a prospective observational study
Ole Kristian Alhaug1, Filip C Dolatowski2, Tore K Solberg3
1Innlandet Hospital Trust, The Research Center for Age-Related Functional Decline and Disease, PO Box 68, N-2313 Ottestad, Norway; Norwegian University of Science and Technology, NTNU PO Box 191, N-7491 Trondheim, Norway; Orthopedic Department, Akershus University Hospital, PO Box 1000, N-1478 Loerenskog, Norway.
For lumbar spinal stenosis (LSS) surgery, over a third of patients experienced failure, and nearly a quarter worsened. Key predictors for poor outcomes include long-term back pain, prior spinal surgery, and age over 70.
Area of Science:
- Neurosurgery
- Orthopedics
- Spinal Surgery Outcomes
Background:
- Lumbar spinal stenosis (LSS) surgery carries risks, and patient selection is crucial for successful outcomes.
- Identifying predictors of surgical failure is essential for improving clinical results in LSS patients.
Purpose of the Study:
- To investigate factors predicting failure and worsening of symptoms after lumbar spinal stenosis surgery.
- To enhance patient selection and optimize surgical outcomes for LSS.
Main Methods:
- Retrospective analysis of prospectively collected data from the Norwegian registry for spine surgery (NORspine).
- Inclusion of 11,873 patients operated for LSS between 2007 and 2017, with 12-month follow-up data from 8919 responders.
- Logistic regression analysis to identify predictors of failure (Oswestry Disability Index [ODI] >31) and worsening (ODI >39).
Main Results:
- 33.2% of patients experienced treatment failure and 21.6% showed worsening of symptoms 12 months post-surgery.
- Strongest predictors for failure and worsening included duration of back pain >12 months, previous spinal surgery, and age >70 years.
- Socioeconomic factors also demonstrated a significant association with increased odds of both failure and worsening.
Conclusions:
- A significant proportion of patients undergoing LSS surgery experience suboptimal outcomes.
- Preoperative factors such as prolonged back pain, prior spinal surgery, and advanced age are critical indicators for potential surgical failure or worsening.
- These findings underscore the importance of careful patient selection and pre-operative counseling in LSS management.
