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The Association Between Lumbar Lordosis Preoperatively And Changes In PROMs For Lumbar Spinal Stenosis Patients 2 Years After Spinal Surgery: Radiological And Clinical Results From The NORDSTEN-Spinal Stenosis Trial London Spine Lumbar Stenosis

The article investigates the association between preoperative lumbar lordosis (LL) and changes in patient-reported outcome measures (PROMs) 2 years after decompressive surgery for lumbar spinal stenosis (LSS). The study, involving 401 patients from the NORDSTEN study, found that there were no associations between preoperative LL and changes in PROMs such as the oswestry disability index, numeric rating scale for pain, Zurich claudication questionnaire, and global perceived effect score. The results suggest that lumbar lordosis should not be a determining factor when considering decompressive surgery for LSS

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

LL before surgery was not associated with changes in PROMs 2 years after surgery. Lumbar lordosis should not be a factor when considering decompressive surgery for LSS.

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Abstract Background: Patients with lumbar spinal stenosis (LSS) sometimes have lower lumbar lordosis (LL), and the incidence of LSS correlates closely with the loss of LL. The few studies that have evaluated the association between LL and clinical outcomes after non-instrumented surgery for LSS show conflicting results. This study investigates the association between preoperative LL,

Abstract

Background: Patients with lumbar spinal stenosis (LSS) sometimes have lower lumbar lordosis (LL), and the incidence of LSS correlates closely with the loss of LL. The few studies that have evaluated the association between LL and clinical outcomes after non-instrumented surgery for LSS show conflicting results. This study investigates the association between preoperative LL and changes in PROMs 2 years after decompressive surgery.

Method: This prospective cohort study obtained preoperative and postoperative data for 401 patients from the multicenter randomized controlled spinal stenosis trial as part of the NORwegian degenerative spondylolisthesis and spinal STENosis (NORDSTEN) study. Before surgery, the radiological sagittal alignment parameter LL was measured using standing X-rays. The association between LL and 2-year postoperative changes was analyzed using the oswestry disability index (ODI), a numeric rating scale (NRS) for low back and leg pain, the Zurich claudication questionnaire (ZCQ), and the global perceived effect (GPE) score. The changes in PROMs 2 years after surgery for quintiles of lumbar lordosis were adjusted for the respective baseline PROMs: age, sex, smoking, and BMI. The Schizas index and the Pfirrmann index were used to analyze multiple regressions for changes in PROMs.

Results: There were no associations in the adjusted and unadjusted analyses between preoperative LL and changes in ODI, ZCQ, GPE, and NRS for back and leg pain 2 years after surgery.

LL before surgery was not associated with changes in PROMs 2 years after surgery. Lumbar lordosis should not be a factor when considering decompressive surgery for LSS.

Keywords: Lumbar lordosis; Lumbar spinal stenosis; Lumbar spine surgery; Patient-related outcome measures.

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Read the original publication:

The association between lumbar lordosis preoperatively and changes in PROMs for lumbar spinal stenosis patients 2 years after spinal surgery: radiological and clinical results from the NORDSTEN-spinal stenosis trial

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Abstract Background: Patients with lumbar spinal stenosis (LSS) sometimes have lower lumbar lordosis (LL), and the incidence of LSS correlates closely with the loss of LL. The few studies that have evaluated the association between LL and clinical outcomes after non-instrumented surgery for LSS show conflicting results. This study investigates the association between preoperative LL

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