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Doing the Math for Best Results after Lumbar Stenosis Surgery
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Posted on: 03/31/2004
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Lumbar spinal stenosis is becoming a common problem among aging adults. What is it and what can be done about it? Lumbar refers to the low back area, and stenosis means narrowing. In spinal stenosis, the spinal canal gets too narrow, and the spinal nerves inside begin to get squeezed.
Treatment for lumbar spinal stenosis is often surgery. Part of the bony ring that covers the spinal nerves is removed to remove pressure. There's been a trend over the past few years towards less invasive operations. Instead of taking the entire bone and nearby joints, only part of the bone is removed above and below the problem level. This operation is called laminarthrectomy.
Doctors are also looking for a way to predict which patients will get better with surgery. The aim of this study was to find a model to predict results. The model is based on information used before the operation.
Before the operation the surgeon examined 45 patients. History, symptoms, and strength were recorded. X-rays and CT scans were done. All tests and measures were repeated one year after the operation. Success was defined as improvement in three of four areas: general health, pain, function, and claudication (pain while walking).
The authors report a 58 percent rate of success by this standard. Most of the rest of the patients improved but only in two areas. They looked at the patients who had a successful result to see which factors might point to a good outcome. The model proposed by the author looks at gender and the presence of calcification in the aorta. They determined that a separate model may be needed for men and women.
The authors don't think their model is ready for use yet. More study must be done. They advise the use of imaging studies to assess blood supply to the spine. Deposits of calcium and hardening of the arteries may be more important in the results than previously thought.
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References:
K. F. Spratt, et al. A Predictive Model for Outcome after Conservative Decompression Surgery for Lumbar Spinal Stenosis. In European Spine Journal. February 2004. Vol. 13. No. 1. Pp. 14-21.
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