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Improvement in predominant back pain following minimally invasive decompression for spinal stenosis – Lumbar Spinal Stenosis

This article, published in the Journal of Neurosurgery: Spine, conducted a retrospective cohort study to assess the outcomes of patients with predominant back pain (pBP) undergoing minimally invasive decompression surgery compared to patients with nonpredominant back pain (npBP). The study analyzed changes in patient-reported outcome measures (PROMs) at different time points postoperatively. The results showed that both pBP and npBP cohorts experienced similar improvement in PROMs and achieved minimal clinically important difference (MCID) rates. Therefore, the study concludes that minimally invasive laminectomy is equally effective for patients regardless of whether they present with pBP or npBP

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : innovative treatment facility on Harley Street UK

Published article

CONCLUSIONS: The pBP and npBP cohorts showed similar improvement in PROMs and MCID achievement rates. This result shows that minimally invasive laminectomy is equally effective for patients presenting with pBP or npBP.

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J Neurosurg Spine. 2023 Jul 14:1-7. doi: 10.3171/2023.5.SPINE23278. Online ahead of print.ABSTRACTOBJECTIVE: The objective of this study was to assess the outcomes of patients with predominant back pain (pBP) undergoing minimally invasive decompression surgery compared with patients with nonpredominant back pain (npBP).METHODS: This was a retrospective cohort study. Patients were divided into two groups based,

J Neurosurg Spine. 2023 Jul 14:1-7. doi: 10.3171/2023.5.SPINE23278. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study was to assess the outcomes of patients with predominant back pain (pBP) undergoing minimally invasive decompression surgery compared with patients with nonpredominant back pain (npBP).

METHODS: This was a retrospective cohort study. Patients were divided into two groups based on the presenting complaint: 1) pBP, defined as visual analog scale (VAS) back pain score > VAS leg pain score; and 2) npBP. Changes in patient-reported outcome measures (PROMs) were compared at the early (< 6 months) and late (≥ 6 months) postoperative time points. Outcomes measures were: 1) PROMs (Oswestry Disability Index [ODI], VAS back and leg pain scores, 12-Item Short-Form Health Survey Physical Component Score [SF-12 PCS], and Patient-Reported Outcomes Measurement Information System Physical Function [PROMIS PF]), and 2) minimal clinically important difference (MCID) achievement rate and time. For the late MCID achievement point, a second analysis was conducted restricting VAS back and leg pain scores only to patients with preoperative scores ≥ 5.

RESULTS: Three hundred ninety patients were included (126 with pBP and 264 with npBP). There were no differences in patient demographics and operated levels. There were no differences in preoperative ODI, SF-12 PCS, and PROMIS PF scores. The pBP cohort had a significantly greater preoperative VAS back pain score than the npBP cohort, whereas the npBP cohort had a significantly greater preoperative VAS leg pain score than the pBP cohort. There were no differences in the absolute values or changes in ODI, VAS back pain, SF-12 PCS, and PROMIS PF scores at any time point. There was a significant difference in the early VAS leg pain scores (greater in npBP) that disappeared by the late postoperative time point. There was no difference in the MCID achievement rate in the ODI, SF-12 PCS, or PROMIS PF scores. By the late postoperative time point, 51.2% and 55.3% achieved an MCID on the ODI, 58.1% and 62.7% on the SF-12 PCS, 60% and 67.6% on the PROMIS PF, 81.1% and 73.2% on VAS back pain scores for those with preoperative scores ≥ 5, and 72% and 83.6% on VAS leg pain scores for those with preoperative scores ≥ 5 for the pBP and npBP cohorts, respectively. Additionally, there were no differences in time to MCID achievement for any PROMs.

CONCLUSIONS: The pBP and npBP cohorts showed similar improvement in PROMs and MCID achievement rates. This result shows that minimally invasive laminectomy is equally effective for patients presenting with pBP or npBP.

PMID:37486867 | DOI:10.3171/2023.5.SPINE23278

The London Spine Unit : innovative treatment facility on Harley Street UK

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Improvement in predominant back pain following minimally invasive decompression for spinal stenosis

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J Neurosurg Spine. 2023 Jul 14:1-7. doi: 10.3171/2023.5.SPINE23278. Online ahead of print.ABSTRACTOBJECTIVE: The objective of this study was to assess the outcomes of patients with predominant back pain (pBP) undergoing minimally invasive decompression surgery compared with patients with nonpredominant back pain (npBP).METHODS: This was a retrospective cohort study. Patients were divided into two groups based

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