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Outcomes and their predictors in lumbar spinal stenosis: a 12-year follow-up

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Abstract

Purpose

The aim of this prospective observational cohort study was to evaluate long-term outcomes in patients with mild-to-moderate lumbar spinal stenosis (LSS) and to analyse the predictors of clinical outcomes.

Methods

A group of 53 patients were re-examined after a median period of 139 months. Evaluations were made of subjective clinical outcome, objective clinical outcome and its predictors, any correlation between subjective and objective outcome, and the development of changes in radiological and electrophysiological parameters after 12 years.

Results

Satisfactory objective and subjective clinical outcomes were recorded in 54.7 and 43.4 % of patients, respectively. No statistically significant correlation between objective and subjective clinical outcome was found (Spearman coefficient = 0.225, p = 0.132). Patients with isolated unsatisfactory subjective outcome exhibited the highest Functional Comorbidity Index of all subgroups. Electrophysiological and radiological findings did not demonstrate statistically significant changes after 12-year follow-up. Multivariate logistic regression confirmed only the lowest transverse diameter of spinal canal ≦13.6 mm as an independent predictor of unsatisfactory clinical outcome (OR = 5.51).

Conclusions

Satisfactory objective and subjective clinical outcomes were disclosed in about half of the patients with mild-to-moderate LSS in a 12-year follow-up. The number of comorbid diseases had an unfavourable effect on subjective evaluation of clinical outcome. The lowest transverse diameter of spinal canal proved to be the only independent predictor of deterioration of clinical status in LSS patients.

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Abbreviations

AP:

Anteroposterior

BMI:

Body mass index

CT:

Computed tomography

EMG:

Electromyography

FCI:

Functional Comorbidity Index

LL:

Lower limb

LSS:

Lumbar spinal stenosis

MRI:

Magnetic resonance imaging

NASS:

North American Spine Society

NC:

Neurogenic claudication

NIS-LSS:

Neurological impairment score in lumbar spinal stenosis

NRS:

Numerical rating scale

OR:

Odds ratio

ODI:

Oswestry Disability Index

ROC:

Receiver operating characteristic

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Authors and Affiliations

  1. Department of Neurology, University Hospital and Masaryk University Brno, Jihlavska 20, 62500, Brno, Czech Republic

    B. Adamova, S. Vohanka & J. Bednarik

  2. CEITEC-Central European Institute of Technology, Masaryk University, Brno, Czech Republic

    B. Adamova, S. Vohanka & J. Bednarik

  3. Institute of Biostatistics and Analyses, Masaryk University, Kamenice 3, 62500, Brno, Czech Republic

    L. Dusek & J. Jarkovsky

  4. Orthopaedic Department, University Hospital and Masaryk University Brno, Jihlavska 20, 62500, Brno, Czech Republic

    R. Chaloupka

Authors
  1. B. Adamova
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  2. S. Vohanka
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  3. L. Dusek
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  4. J. Jarkovsky
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  5. R. Chaloupka
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  6. J. Bednarik
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Correspondence to B. Adamova.

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Adamova, B., Vohanka, S., Dusek, L. et al. Outcomes and their predictors in lumbar spinal stenosis: a 12-year follow-up. Eur Spine J 24, 369–380 (2015). https://doi.org/10.1007/s00586-014-3411-y

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  • DOI: https://doi.org/10.1007/s00586-014-3411-y

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