Dataset Information

Postoperative Dural Sac Cross-sectional Area as an Association for Outcome after Surgery for Lumbar Spinal Stenosis. Clinical and Radiological Results from the Nordsten-spinal Stenosis Trial.

ABSTRACT:

Study design

Prospective cohort study.

Objective

To investigate the association between postoperative Dural Sac Cross-sectional Area (DSCA) after decompressive surgery for Lumbar Spinal Stenosis (LSS), and clinical outcome. Furthermore, to investigate if there is a minimum threshold for how extensive a posterior decompression needs to be to achieve a satisfactory clinical result.

Summary of background data

There is limited scientific evidence for how extensive a lumbar decompression needs to be to obtain a good clinical outcome in patients with symptomatic LSS.

Methods

All patients were included from the Spinal Stenosis Trial (SST) of the NORwegian Degenerative spondylolisthesis and spinal STENosis (NORDSTEN)-study. The patients underwent decompression according to 3 different methods. DSCA measured on lumbar MRI at baseline and at three months follow up, and patient reported outcome at baseline and at two-year follow up were registered in a total of 393 patients. Mean age was 68 (SD 8.3), proportion of males were 204/393 (52%), proportion of smokers were 80/393 (20%), and mean BMI was 27.8 (SD 4.2).The cohort was divided into quintiles based on the achieved DSCA postoperatively, numeric, and relative increase of DSCA, and the association between the increase in DSCA and clinical outcome were evaluated.

Results

At baseline, the mean DSCA in the whole cohort was 51.1 mm2 (SD 21.1). Postoperatively the area increased to a mean area of 120.6 mm2 (SD 46.9). The change in ODI in the quintile with the largest DSCA was -22.0 (95% CI: -25.6 - -18), and in the quintile with the lowest DSCA the ODI change was -18.9 (95% CI: -22.4 - -15.3). There were only minor differences in clinical improvement for patients in the different DSCA quintiles.

Conclusion

Less aggressive decompression performed similarly to wider decompression across multiple different patient-reported outcome measures at 2 years following surgery.

SUBMITTER: Hermansen E

PROVIDER: S-EPMC10118242 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Postoperative Dural Sac Cross-Sectional Area as an Association for Outcome After Surgery for Lumbar Spinal Stenosis: Clinical and Radiological Results From the NORDSTEN-Spinal Stenosis Trial.

Hermansen Erland E Myklebust Tor Å TÅ Weber Clemens C Brisby Helena H Austevoll Ivar M IM Hellum Christian C Storheim Kjersti K Aaen Jørn J Banitalebi Hasan H Brox Jens I JI Grundnes Oliver O Rekeland Frode F Solberg Tore T Franssen Eric E Indrekvam Kari K

Spine 20230220 10

<h4>Study design</h4>Prospective cohort study.<h4>Objective</h4>The aim was to investigate the association between postoperative dural sac cross-sectional area (DSCA) after decompressive surgery for lumbar spinal stenosis and clinical outcome. Furthermore, to investigate if there is a minimum threshold for how extensive a posterior decompression needs to be to achieve a satisfactory clinical result.<h4>Summary of background data</h4>There is limited scientific evidence for how extensive lumbar d ...[more]

PMID: 36809364

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