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Facet Joint Opening On Computed Tomography Is A Predictor Of Poor Clinical Outcomes After Minimally Invasive Decompression Surgery For Lumbar Spinal Stenosis London Spine

The London Spine Unit : innovative day surgery unit on Harley Street UK

Published article

FJO at both index decompression level and multiple level were predictors of poor outcomes; patients with FJOs require careful surgical planning or special follow-up.Level of Evidence: 3.Lumbar Disc Replacement Expert. Best Spinal Surgeon UK

Abstract

Study design: Retrospective longitudinal cohort study.

Objective: To investigate the impact of facet joint opening (FJO) on clinical outcomes after minimally invasive decompression surgery for lumbar spinal stenosis.

Summary of background data: Although FJOs have previously been identified as indicators of segmental spinal instability, their impact on clinical outcomes after decompression alone surgery has yet to be investigated.

Methods: This study included 296 patients from a single institution who underwent minimally invasive surgery for lumbar spinal stenosis and were followed up for ≥5 years. Our analysis focused on identifying FJOs at the index decompression level (d-FJO) and at multiple levels (m-FJO) (i.e., ≥3 levels within the lumbar segment) using preoperative computed tomography. Clinical outcomes including reoperations, improvement ratio for Japanese Orthopaedic Association (JOA) score, and achievement of a minimal clinically important difference (MCID) in visual analogue scale (VAS) scores for low back pain (LBP) or leg pain at 5 years were compared between patients with and without d-FJO or m-FJO.

Results: There were 129 (44%) and 62 (21%) patients with d-FJO (more common with lateral olisthesis) and m-FJO (less common with spondylolisthesis), respectively. Reoperations were more common in patients with d-FJO than in those without (16% vs. 5%). On Cox proportional hazards analysis, d-FJO was identified as a predictor for revision at the index decompression level , whereas m-FJO was a predictor for revision at other lumbar levels (HR 3.71, p = 0.03). Patients with m-FJO had slightly lower rates of achieving MCID in VAS scores for LBP (34% vs. 52%, p = 0.03) and poorer improvement ratio forJOA scores (74% vs. 80%, p = 0.03) than those without.

FJO at both index decompression level and multiple level were predictors of poor outcomes; patients with FJOs require careful surgical planning or special follow-up.Level of Evidence: 3.

The London Spine Unit : innovative day surgery unit on Harley Street UKRead the original here:Facet Joint Opening on Computed Tomography is a Predictor of Poor Clinical Outcomes After Minimally Invasive Decompression Surgery for Lumbar Spinal Stenosis

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Abstract Study design: Retrospective longitudinal cohort study. Objective: To investigate the impact of facet joint opening (FJO) on clinical outcomes after minimally invasive decompression surgery for lumbar spinal stenosis. Summary of background data: Although FJOs have previously been identified as indicators of segmental spinal instability, their impact on clinical outcomes after decompression alone surgery has…

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