The London Spine Unit : most established spine hospital in the world
Published article
LTM is an effective treatment for lumbar spinal stenosis with sustained 6 year PROs. Most failures occur within 2 years postoperatively and stabilize to 4% yearly incidence by year 5. The yearly incidence of re-operation with LTM stabilizes at 3% by year 6 post operatively.
Lumbar Disc Replacement Expert. Best Spinal Surgeon UK
Abstract
Study design: Prospective cohort study.
Objective: To report re-operation rates following lumbar tubular microdecompression (LTM) as well as compare patient reported outcomes (PROs) 6 years after surgery between those who did and did not need revision at the index level.
Summary of background data: Long term data describing PROs and re-operation rates following LTMs are lacking.
Methods: Patients with lumbar spinal stenosis underwent one or more of three LTM procedures. Demographic, PROs [Oswestry Disability Index (ODI) and visual analog scale (VAS) for back and leg pain], and re-operation data were collected. Failure of an index LTM was defined as any revision surgery at the index level. Revision LTM at a different level was not considered failure. Failure and revision LTM incidence at a different level and cumulative incidence were prospectively collected up to six years. Mixed effects linear regressions with 95% confidence intervals (95% CI) were performed to assess potential differences in ODI and reported VAS back and leg pain between patients that reported failure and those that did not.
Results: 418 patients were included with median follow up of 3.0 (1.9, 4.1) years. 25% had a reoperation by 6 years. 65 (16%) failed and 35 (9%) underwent a second LTM at another level. Cumulative failure incidence was 9% within the first two years. Failure patients had a statistically higher ODI [12.1 (95% CI: 3.2, 20.1) and VAS back [2.3 (95% CI: 0.9, 3.8)] and leg pain [1.6 (95% CI: 0.2, 3.1)] throughout followup. The overall dural tear rate was 7.2%.
LTM is an effective treatment for lumbar spinal stenosis with sustained 6 year PROs. Most failures occur within 2 years postoperatively and stabilize to 4% yearly incidence by year 5. The yearly incidence of re-operation with LTM stabilizes at 3% by year 6 post operatively.
Level of evidence: 2.
The London Spine Unit : most established spine hospital in the world
Read more from the original source:
Patient Reported Outcomes and Reoperation Rates Following Lumbar Tubular Microdecompression: 6 Year Follow Up