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Does low-back pain improve after decompressive spinal surgery? A prospective observational study from the British Spine Registry – Lumbar Spinal Stenosis

A study published in the Journal of Neurosurgery: Spine analyzed data from the British Spine Registry to examine the impact of lumbar spine decompression surgery on low-back pain (LBP). The study found that 62% of patients who underwent lumbar decompressive surgery reported a meaningful improvement in LBP, with 51% experiencing a substantial improvement. The improvement was observed as early as 6 weeks post-surgery and was mostly maintained at the two-year mark. The severity of baseline back pain did not affect the proportion of patients attaining the clinically important reduction in pain. The study suggests that patients undergoing lumbar decompression can be advised on the likelihood of a meaningful improvement in back pain after surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

CONCLUSIONS: Regardless of pain presentation, LBP improves in approximately 62% of patients who undergo lumbar decompressive surgery, with 51% experiencing substantial improvement. Patients undergoing lumbar decompression can be advised on the chance of a meaningful improvement in back pain postsurgery.

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J Neurosurg Spine. 2023 Jul 14:1-10. doi: 10.3171/2023.5.SPINE23116. Online ahead of print.ABSTRACTOBJECTIVE: Lumbar spine decompression surgery, in the form of laminectomy or discectomy, is known to be effective in improving symptoms of radiculopathy and neurogenic claudication. However, it is less clear how it impacts coexisting low-back pain (LBP). The aim of this study was to,

J Neurosurg Spine. 2023 Jul 14:1-10. doi: 10.3171/2023.5.SPINE23116. Online ahead of print.

ABSTRACT

OBJECTIVE: Lumbar spine decompression surgery, in the form of laminectomy or discectomy, is known to be effective in improving symptoms of radiculopathy and neurogenic claudication. However, it is less clear how it impacts coexisting low-back pain (LBP). The aim of this study was to quantify the change in LBP after lumbar decompression.

METHODS: This study analyzed data from the British Spine Registry on patients who underwent lumbar decompression surgery. LBP severity was assessed using the visual analog scale (VAS), and the primary outcome was the change in VAS score at 1 year, with secondary outcomes measuring the change in score at 6 weeks, 6 months, and 2 years. The minimal clinically important difference (MCID) was defined as a 30% reduction in pain.

RESULTS: Of the 25,349 patients included in the study, 92.2% reported significant back pain at baseline. Of the entire cohort, 12,951 (55.4%) patients had follow-up data for 6 weeks, 9066 (38.8%) for 6 months, 7926 (33.9%) for 1 year, and 5517 (23.6%) for 2 years; 17,304 (68.3%) patients had follow-up data for at least one time point. Sixty-two percent of patients attained the MCID (VAS score ≥ 30%) in back pain reduction, with 51% reporting a substantial improvement (VAS score ≥ 50%). This improvement was observed by 6 weeks postoperation and was mostly maintained at 2 years. Patients with back pain predominance were more likely to attain the MCID compared with those with leg pain predominance (63.6% vs 60.1%; OR 1.16, 95% CI 1.02-1.34; p = 0.0291). Severity of baseline back pain did not reduce the proportion attaining the MCID.

CONCLUSIONS: Regardless of pain presentation, LBP improves in approximately 62% of patients who undergo lumbar decompressive surgery, with 51% experiencing substantial improvement. Patients undergoing lumbar decompression can be advised on the chance of a meaningful improvement in back pain postsurgery.

PMID:37486861 | DOI:10.3171/2023.5.SPINE23116

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Does low-back pain improve after decompressive spinal surgery? A prospective observational study from the British Spine Registry

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J Neurosurg Spine. 2023 Jul 14:1-10. doi: 10.3171/2023.5.SPINE23116. Online ahead of print.ABSTRACTOBJECTIVE: Lumbar spine decompression surgery, in the form of laminectomy or discectomy, is known to be effective in improving symptoms of radiculopathy and neurogenic claudication. However, it is less clear how it impacts coexisting low-back pain (LBP). The aim of this study was to

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