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Incidence Of Subsequent Surgical Decompression Following Minimally Invasive Approaches To Treat Lumbar Spinal Stenosis: A Retrospective Review London Spine Lumbar Stenosis

The article discusses the use of minimally invasive procedures as an alternative to surgical decompression for treating symptomatic lumbar spinal stenosis. The study aimed to evaluate the incidence and characteristics of patients who ultimately required surgical decompression after undergoing minimally invasive procedures. The retrospective review included 5,278 patients who underwent Percutaneous Image-guided Lumbar Decompression (PILD) or interspinous spacer device (ISD) placement. The results showed that 6.56% of patients required subsequent surgical decompression within five years. Factors such as male gender and prior history of surgical decompression increased the likelihood of subsequent surgery, while older age, obesity, and a higher Charlson Comorbidity Index score reduced it. The findings provide valuable insights for selecting suitable surgical candidates and improving outcomes for elderly patients with lumbar spinal stenosis

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most experienced spine facility on Harley Street UK

Published article

CONCLUSIONS: Minimally invasive procedures may provide an additional option to treat symptomatic lumbar spinal stenosis in patients who are poor surgical candidates or who do not desire open decompression; however, there still exists a subset of patients who will require subsequent surgical decompression. Factors such as gender and prior surgical decompression increase the likelihood of subsequent surgery, while older age, obesity, and a higher Charlson Comorbidity Index score reduce it. These…

Spine Lumbar Spinal Stenosis Expert. Best Spinal Surgeon UK
Abstract Background context: Surgical decompression is the definitive treatment for managing symptomatic lumbar spinal stenosis; however, select patients are poor surgical candidates. Consequently, minimally invasive procedures have gained popularity, but there exists the potential for failure of therapy necessitating eventual surgical decompression. Purpose: To evaluate the incidence and characteristics of patients who require surgical decompression,

Abstract

Background context: Surgical decompression is the definitive treatment for managing symptomatic lumbar spinal stenosis; however, select patients are poor surgical candidates. Consequently, minimally invasive procedures have gained popularity, but there exists the potential for failure of therapy necessitating eventual surgical decompression.

Purpose: To evaluate the incidence and characteristics of patients who require surgical decompression following minimally invasive procedures to treat lumbar spinal stenosis.

Study design/setting: Retrospective review.

Patient sample: Patients who underwent minimally invasive procedures for lumbar spinal stenosis (Percutaneous Image-guided Lumbar Decompression [PILD] or interspinous spacer device [ISD]) progressed to subsequent surgical decompression within 5 years.

Outcome measures: The primary outcome was the rate of surgical decompression within 5 years following the minimally invasive approach. Secondary outcomes included demographic and comorbid factors associated with increased odds of requiring subsequent surgery.

Methods: Patient data were collected using the PearlDiver-Mariner database. The rate of subsequent decompression was described as a percentage while univariable and multivariable regression analysis was used for the analysis of predictors.

Results: A total of 5278 patients were included, of which 3222 (61.04%) underwent PILD, 1959 (37.12%) underwent ISD placement, and 97 (1.84%) had claims for both procedures. Overall, the incidence of subsequent surgical decompression within 5 years was 6.56% (346 of 5278 patients). Variables associated with a significantly greater odds ratio (OR) [95% confidence interval (CI)] of requiring subsequent surgical decompression included male gender and a prior history of surgical decompression by 1.42 ([1.14, 1.77]p = 0.002) and 2.10 times ([1.39, 3.17]p < 0.001), respectively. In contrast, age 65 years and above, a diagnosis of obesity, and a Charlson Comorbidity Index score of three or greater were associated with a significantly reduced OR [95% CI] by 0.64 ([0.50, 0.81]p < 0.001), 0.62 ([0.48, 0.81]p < 0.001), and 0.71 times ([0.56, 0.91]p = 0.007), respectively.

Conclusions: Minimally invasive procedures may provide an additional option to treat symptomatic lumbar spinal stenosis in patients who are poor surgical candidates or who do not desire open decompression; however, there still exists a subset of patients who will require subsequent surgical decompression. Factors such as gender and prior surgical decompression increase the likelihood of subsequent surgery, while older age, obesity, and a higher Charlson Comorbidity Index score reduce it. These findings aid in selecting suitable surgical candidates for better outcomes in the elderly population with lumbar spinal stenosis.

Keywords: degenerative disc pain/disease; lumbar spinal stenosis and degenerative spondylolisthesis; spondylolisthesis/spondylolysis.

The London Spine Unit : most experienced spine facility on Harley Street UK

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Incidence of subsequent surgical decompression following minimally invasive approaches to treat lumbar spinal stenosis: A retrospective review

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Abstract Background context: Surgical decompression is the definitive treatment for managing symptomatic lumbar spinal stenosis; however, select patients are poor surgical candidates. Consequently, minimally invasive procedures have gained popularity, but there exists the potential for failure of therapy necessitating eventual surgical decompression. Purpose: To evaluate the incidence and characteristics of patients who require surgical decompression

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