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Short- and Long-Term Outcome of Microscopic Lumbar Spine Surgery in Patients with Predominant Back or Predominant Leg Pain

Stienen, Martin N.
Joswig, Holger
Smoll, Nicolas R.
Hildebrandt, Gerhard
Published in World Neurosurgery. 2016, vol. 93, p. 458-465.e1
Abstract Abstract OBJECTIVE: This study assessed whether predominant back pain (pBP) represents a negative outcome predictor in patients undergoing microscopic spine surgery without fusion for a lumbar disc herniation (LDH) or spinal stenosis (LSS). METHODS: Retrospective analysis of prospectively collected data on consecutive patients with LDH or LSS at 2 centers. Patients with visual analog scale (VAS) back pain ≥VAS leg pain were assigned to the pBP group, and compared with patients with predominant VAS leg pain (pLP). Outcome measures included the Roland-Morris Disability Index (RMDI), Oswestry Disability Index (ODI), health-related quality of life measures, Short-Form (SF)-12 Physical Component Summary (PCS), and EuroQol (EQ-5D) index at 3 days, 6 weeks (W6), 6 months, and 1 year postoperatively. RESULTS: A total of 325 patients (154 [47.4%] with pBP and 171 [52.6%] with pLP) were included. Patients with pBP were about 6 years older and more often had LSS. There was no significant difference between the group means of the RMDI, ODI, SF-12 PCS, or EQ-5D at any postoperative time point. The most improvement was observed until the W6 follow-up with little or no improvement thereafter up to 1 year postoperatively. Patients with pBP were as likely as patients with pLP to be W6 responders on the RMDI (odds ratio [OR], 0.91; 95% confidence interval [CI], 0.38-2.16; P = 0.831), ODI (OR, 1.00; 95% CI 0.52-1.92; P = 0.996), SF-12 PCS (OR, 1.09; 95% CI 0.58-2.04; P = 0.791), and EQ-5D (OR, 0.62; 95% CI 0.32-1.21; P = 0.164). Disease-specific subgroup analyses confirmed the results. CONCLUSIONS: The present data suggest that patients with pBP have comparable functional and health-related quality of life outcomes after surgery for LDH or LSS with those of patients with pLP.
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Research group Groupe Schaller Karl Lothard (neurochirurgie) (851)
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STIENEN, Martin N. et al. Short- and Long-Term Outcome of Microscopic Lumbar Spine Surgery in Patients with Predominant Back or Predominant Leg Pain. In: World Neurosurgery, 2016, vol. 93, p. 458-465.e1. doi: 10.1016/j.wneu.2016.06.120 https://archive-ouverte.unige.ch/unige:100386

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Deposited on : 2017-12-15

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