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The Influence Of Spinous Process Union On Clinical Outcomes After Spinous Process Osteotomy For Lumbar Spinal Stenosis After 2 Years: A Secondary Analysis From The NORDSTEN-Study London Spine Lumbar Stenosis

The study aimed to investigate the association between complete radiological healing after spinous process (SP) osteotomy and clinical outcomes in patients with lumbar spinal stenosis. The retrospective cohort study included 102 patients, with 75.5% classified as having complete SP union. However, the study found no influence of SP union on the success rate or mean change in the Oswestry Disability Index (ODI) after 2 years. This suggests that SP union, as classified by computed tomography, does not impact clinical outcomes following SP osteotomy in patients with lumbar spinal stenosis. The study provides valuable information to help surgeons choose the most appropriate decompressive technique for patients with this condition

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

CONCLUSIONS: We found no influence of SP union, classified by computed tomography, on clinical outcome 2 years after SP osteotomy in patients with lumbar spinal stenosis.

Spine Lumbar Spinal Stenosis Expert. Best Spinal Surgeon UK
Abstract Background: Lumbar spinal stenosis is a prevalent and increasingly important cause of low back pain, leg pain, and walking impairment. Minimally invasive decompressive techniques such as spinous process (SP) osteotomy have become more common in recent years. The main aim of this study was to investigate the proportion of complete SP union and whether,

Abstract

Background: Lumbar spinal stenosis is a prevalent and increasingly important cause of low back pain, leg pain, and walking impairment. Minimally invasive decompressive techniques such as spinous process (SP) osteotomy have become more common in recent years. The main aim of this study was to investigate the proportion of complete SP union and whether complete radiological healing after the osteotomy is associated with superior clinical outcome after 2 years.

Methods: In this retrospective cohort study, 149 patients were included from the Spinal Stenosis Trial, a part of the NORwegian Degenerative spondylolisthesis and spinal STENosis study. Computed tomography imaging was performed 2 years postoperatively. The number of osteotomies and the number of SP unions were recorded. Patients were divided into groups based on the degree of union: nonunion, partial union, and complete union. Rate of success (>30% improvement in Oswestry Disability Index [ODI]) and mean change in ODI were the primary outcome measures. We compared the differences between baseline and follow-up between the Degree of Union groups.

Results: The study included 102 of 149 eligible patients. Ten patients (9.8%) were classified as having nonunion, 15 (14.7%) as having partial union, and 77 (75.5%) as having complete union. Of the 155 osteotomies, there were 122 classified as union (77%). The success rate was 74%, with no influence of SP union. The mean change in the ODI was -20.1 (95% CI -37.0, 14.2) with no influence of SP union.

Conclusions: We found no influence of SP union, classified by computed tomography, on clinical outcome 2 years after SP osteotomy in patients with lumbar spinal stenosis.

Clinical relevance: Supplying useful information about SPO to assist surgeons in the choice of decompressive technique.

Keywords: laminotomy; lumbar spinal stenosis; posterior decompression; spinous process osteotomy.

The London Spine Unit : most experienced spinal clinic on Harley Street UK

Read the original publication:

The Influence of Spinous Process Union on Clinical Outcomes After Spinous Process Osteotomy for Lumbar Spinal Stenosis After 2 Years: A Secondary Analysis From the NORDSTEN-Study

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Abstract Background: Lumbar spinal stenosis is a prevalent and increasingly important cause of low back pain, leg pain, and walking impairment. Minimally invasive decompressive techniques such as spinous process (SP) osteotomy have become more common in recent years. The main aim of this study was to investigate the proportion of complete SP union and whether

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