Key result
Age under 75 years strongly predicted good postoperative satisfaction (OR 4.03; 95% CI 1.35-12.02; p=0.012) in patients undergoing surgery for lumbar spinal stenosis at two-year follow-up.
Why the study?
What are the preoperative predictors for good postoperative satisfaction and functional outcome in patients undergoing lumbar spinal stenosis surgery?
Observational (n=102)
What are the preoperative predictors for good postoperative satisfaction and functional outcome in patients undergoing lumbar spinal stenosis surgery?
Odds Ratio: 4.03 (95% CI 1.35–12.02)
p-value: p=0.012
In patients undergoing surgery for lumbar spinal stenosis, age under 75, no prior lumbar surgery, shorter duration of preoperative analgesic use, non-smoking, and good self-rated health predict better postoperative satisfaction and functional outcomes.
May inform age-based expectations after lumbar stenosis surgery; hypothesis-generating pending prospective confirmation.
BACKGROUND AND AIMS: Lumbar spinal stenosis (LSS) is the most frequent indication for back surgery in adults aged over 65 years, but about one-third of operated patients have less than good/excellent results from the operation. Awareness of outcome predictors and their predictive values may help clinicians in their assessment of the prognosis of patients when considering surgical treatment. Our aim was to study the preoperative predictors in LSS for a good postoperative outcome (satisfaction with surgery and functional improvement) with a two-year follow-up. MATERIAL AND METHODS: LSS patients (n = 102) completed a questionnaire preoperatively and on two-year follow-up. Preoperative patient-related predictors, self-rated health, comorbidities and preoperative treatment were assessed. Satisfaction with the surgical outcome was assessed with a seven-category scale; satisfaction was determined to be good if the patient response was "condition has considerably improved" or "totally cured". Other responses ("condition has slightly improved" or worse) represented poorer satisfaction. A good functional outcome was determined as >30% relative improvement compared to the presurgery score in the Oswestry Disability Index (ODI). RESULTS: The predictors for good satisfaction were age < 75 years at operation (OR 4.03; 95% CI 1.35-12.02; p = 0.012) and no previous lumbar operation (OR 3.65; 95% CI 1.13-11.79; p = 0.031). Predictors for a good improvement in the ODI score were regular preoperative analgesic use < 12 months (OR 3.40; 95% CI 1.21-9.53; p = 0.020), non-smoking (OR 3.47; 95% CI 1.09-11.03; p = 0.035) and good (above average) self-rated health (OR 3.27; 95% CI 1.06-10.12; p = 0.039). CONCLUSIONS: In LSS, regular analgesic treatment preoperatively for 12 months or less, self-rated health above average and non-smoking predicted a good postoperative functional improvement. An age under 75 years and no previous lumbar operation predicted good post-operative satisfaction with the surgery.
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Aalto et al. (2012) conducted an observational in Lumbar spinal stenosis (LSS) (n=102). Preoperative predictors (e.g., age < 75 years, non-smoking, good self-rated health) vs. Absence of these predictors was evaluated on Good satisfaction with surgery (OR 4.03, 95% CI 1.35-12.02, p=0.012). Age under 75 years strongly predicted good postoperative satisfaction (OR 4.03; 95% CI 1.35-12.02; p=0.012) in patients undergoing surgery for lumbar spinal stenosis at two-year follow-up.
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