Unfolding the outcomes of surgical treatment of lumbar spinal stenosis-a prospective 5-and 10-year follow-up study
Unfolding the outcomes of surgical treatment of lumbar spinal stenosis-a prospective 5-and 10-year follow-up study
复制标题
DOI：
10.1007/s00586-020-06424-5
复制
发表时间：
2020-04-27
影响因子：
2.8
通讯作者：
Airaksinen, O.
中科院分区：
文献类型：
--
作者：
Tuomainen, I.;Aalto, T.;Airaksinen, O.
目的在这项前瞻性研究中，我们的目的是确定腰椎管狭窄症（LSS）患者术后10年的手术结果。方法研究人群包括96例接受减压手术的LSS患者，其中72例参加了10年的随访。患者在术前和术后3个月、5年和10年完成了问卷调查。结果指标为手术结果满意度、奥斯韦斯特里功能障碍指数（ODI）、视觉模拟量表（VAS）、数字评定量表（NRS-11）和步行能力（以米为单位）。使用线性混合模型分析5年和10年的术后改善。此外，比较术后时间点的疼痛、残疾和行走能力的临床病程。结果随访10年，68%的患者对手术效果满意。所有测量的结局均显示从基线到5年和10年随访的统计学显著改善。与3个月随访时相比，5年随访时的平均VAS评分高9.8 mm，10年随访时高7.8 mm。同样，10年随访时的平均ODI比3个月随访时高4.8%。结论本研究报告了LSS手术后10年随访的疼痛、残疾和步行距离的临床过程。根据我们的研究结果，LSS患者的背部手术可能会产生长达10年的积极影响。然而，在10年随访期间，可能会发生轻微的疼痛和残疾恶化，四分之一的患者可能需要再次手术。
Purpose In this prospective study, we aim to determine surgical outcomes in patients with lumbar spinal stenosis (LSS) 10 years after surgery. Methods The study population consisted of 96 LSS patients who underwent decompressive surgery, 72 of whom participated in the 10-year follow-up. The patients completed a questionnaire preoperatively and 3 months, 5 years, and 10 years postoperatively. Outcome measures were satisfaction with the surgical outcomes, the Oswestry Disability Index (ODI), the visual analog scale (VAS), the numeric rating scale (NRS-11), and walking ability quantified in meters. Postoperative improvements at 5 and 10 years were analyzed using linear mixed models. Furthermore, comparisons between postoperative time points were made for clinical courses of pain, disability, and walking ability. Results At the 10-year follow-up, 68% of the patients were satisfied with the surgical outcomes. All the measured outcomes showed statistically significant improvement from baseline to the 5- and 10-year follow-up. The mean VAS score was 9.8 mm higher at the 5-year follow-up and 7.8 mm at the 10-year follow-up compared to the 3-month follow-up point. Similarly, the mean ODI was 4.8% higher at the 10-year follow-up compared to the 3-month follow-up point. Conclusion This study reports the clinical course of pain, disability, and walking distance after LSS surgery with the 10-year follow-up. Based on our study results, patients with LSS could expect to have positive effects of their back surgery up to 10 years. However, minor worsening in pain and disability may occur and one-fourth of the patients may need a reoperation during the 10-year follow-up period.