A prospective study of recovery from leg numbness following decompression surgery for lumbar spinal stenosis
Residual leg numbness (LN) following lumbar surgery can lower patient satisfaction; however, prospective studies are sparse. The purpose of this study was to evaluate recovery from LN following decompression surgery for lumbar spinal stenosis (LSS). A total of 145 patients with LSS were enrolled. Al...
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| Veröffentlicht in: | Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2017-07, Vol.22 (4), p.670-675 |
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| container_title | Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association |
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| creator | Oba, Hiroki Tsutsumimoto, Takahiro Yui, Mutsuki Kamanaka, Takayuki Ohta, Hiroshi Kosaku, Hidemi Misawa, Hiromichi |
| description | Residual leg numbness (LN) following lumbar surgery can lower patient satisfaction; however, prospective studies are sparse. The purpose of this study was to evaluate recovery from LN following decompression surgery for lumbar spinal stenosis (LSS).
A total of 145 patients with LSS were enrolled. All patients underwent decompressive surgery, with or without spinal fusion, followed by a 12 month prospective follow-up. The degree of LN and leg pain (LP) was assessed using the visual analog scale (VAS), a patient-reported outcome measure.
Six patients dropped out, and we evaluated 139 patients (average age, 68.1 years). The average VAS-LN scores were 5.9 ± 2.6, 1.8 ± 2.3, 2.0 ± 2.5, 2.1 ± 2.6, 2.2 ± 2.5, and 2.1 ± 2.6, and the average VAS-LP scores were 5.7 ± 2.8, 1.2 ± 1.7, 0.9 ± 1.5, 1.4 ± 2.0, 1.4 ± 2.0, and 1.4 ± 1.9 preoperatively and at 2 weeks, 3, 6, 9, 12 months following the surgery, respectively. Significant improvement in VAS-LN and VAS-LP scores was observed during the first 2 weeks after the surgery. At 12 months after the surgery, the VAS-LN score was significantly greater than the VAS-LP score. The change in the VAS-LN score between the preoperative and 12 month-postoperative values was significantly smaller than that in the VAS-LP score. Multivariate logistic analyses revealed that preoperative symptom duration and preoperative dural sac cross-sectional area (DCSA) were the significant independent predictive factors for residual LN.
Following lumbar decompression surgery, LN improved significantly during the first 2 weeks after surgery. However, the improvement in the VAS-LN score was less than in the VAS-LP score. Patients with longer preoperative symptom duration and narrow preoperative DCSA showed less LN improvement.
Level 3. |
| doi_str_mv | 10.1016/j.jos.2017.04.004 |
| format | Article |
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A total of 145 patients with LSS were enrolled. All patients underwent decompressive surgery, with or without spinal fusion, followed by a 12 month prospective follow-up. The degree of LN and leg pain (LP) was assessed using the visual analog scale (VAS), a patient-reported outcome measure.
Six patients dropped out, and we evaluated 139 patients (average age, 68.1 years). The average VAS-LN scores were 5.9 ± 2.6, 1.8 ± 2.3, 2.0 ± 2.5, 2.1 ± 2.6, 2.2 ± 2.5, and 2.1 ± 2.6, and the average VAS-LP scores were 5.7 ± 2.8, 1.2 ± 1.7, 0.9 ± 1.5, 1.4 ± 2.0, 1.4 ± 2.0, and 1.4 ± 1.9 preoperatively and at 2 weeks, 3, 6, 9, 12 months following the surgery, respectively. Significant improvement in VAS-LN and VAS-LP scores was observed during the first 2 weeks after the surgery. At 12 months after the surgery, the VAS-LN score was significantly greater than the VAS-LP score. The change in the VAS-LN score between the preoperative and 12 month-postoperative values was significantly smaller than that in the VAS-LP score. Multivariate logistic analyses revealed that preoperative symptom duration and preoperative dural sac cross-sectional area (DCSA) were the significant independent predictive factors for residual LN.
Following lumbar decompression surgery, LN improved significantly during the first 2 weeks after surgery. However, the improvement in the VAS-LN score was less than in the VAS-LP score. Patients with longer preoperative symptom duration and narrow preoperative DCSA showed less LN improvement.
Level 3.</description><identifier>ISSN: 0949-2658</identifier><identifier>EISSN: 1436-2023</identifier><identifier>DOI: 10.1016/j.jos.2017.04.004</identifier><identifier>PMID: 28456353</identifier><language>eng</language><publisher>Japan: Elsevier B.V</publisher><subject>Aged ; Decompression, Surgical ; Female ; Follow-Up Studies ; Humans ; Hypesthesia - etiology ; Hypesthesia - surgery ; Leg ; Lumbar Vertebrae ; Male ; Middle Aged ; Prospective Studies ; Recovery of Function ; Spinal Fusion ; Spinal Stenosis - complications ; Spinal Stenosis - surgery ; Treatment Outcome</subject><ispartof>Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association, 2017-07, Vol.22 (4), p.670-675</ispartof><rights>2017 The Japanese Orthopaedic Association</rights><rights>Copyright © 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c443t-9a17ae0d14e27a1d6e37a9dc2ce343a17e0fcfe123f508c0339d45caa6af9e8d3</citedby><cites>FETCH-LOGICAL-c443t-9a17ae0d14e27a1d6e37a9dc2ce343a17e0fcfe123f508c0339d45caa6af9e8d3</cites><orcidid>0000-0001-7087-3753</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28456353$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Oba, Hiroki</creatorcontrib><creatorcontrib>Tsutsumimoto, Takahiro</creatorcontrib><creatorcontrib>Yui, Mutsuki</creatorcontrib><creatorcontrib>Kamanaka, Takayuki</creatorcontrib><creatorcontrib>Ohta, Hiroshi</creatorcontrib><creatorcontrib>Kosaku, Hidemi</creatorcontrib><creatorcontrib>Misawa, Hiromichi</creatorcontrib><title>A prospective study of recovery from leg numbness following decompression surgery for lumbar spinal stenosis</title><title>Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association</title><addtitle>J Orthop Sci</addtitle><description>Residual leg numbness (LN) following lumbar surgery can lower patient satisfaction; however, prospective studies are sparse. The purpose of this study was to evaluate recovery from LN following decompression surgery for lumbar spinal stenosis (LSS).
A total of 145 patients with LSS were enrolled. All patients underwent decompressive surgery, with or without spinal fusion, followed by a 12 month prospective follow-up. The degree of LN and leg pain (LP) was assessed using the visual analog scale (VAS), a patient-reported outcome measure.
Six patients dropped out, and we evaluated 139 patients (average age, 68.1 years). The average VAS-LN scores were 5.9 ± 2.6, 1.8 ± 2.3, 2.0 ± 2.5, 2.1 ± 2.6, 2.2 ± 2.5, and 2.1 ± 2.6, and the average VAS-LP scores were 5.7 ± 2.8, 1.2 ± 1.7, 0.9 ± 1.5, 1.4 ± 2.0, 1.4 ± 2.0, and 1.4 ± 1.9 preoperatively and at 2 weeks, 3, 6, 9, 12 months following the surgery, respectively. Significant improvement in VAS-LN and VAS-LP scores was observed during the first 2 weeks after the surgery. At 12 months after the surgery, the VAS-LN score was significantly greater than the VAS-LP score. The change in the VAS-LN score between the preoperative and 12 month-postoperative values was significantly smaller than that in the VAS-LP score. Multivariate logistic analyses revealed that preoperative symptom duration and preoperative dural sac cross-sectional area (DCSA) were the significant independent predictive factors for residual LN.
Following lumbar decompression surgery, LN improved significantly during the first 2 weeks after surgery. However, the improvement in the VAS-LN score was less than in the VAS-LP score. Patients with longer preoperative symptom duration and narrow preoperative DCSA showed less LN improvement.
Level 3.</description><subject>Aged</subject><subject>Decompression, Surgical</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Hypesthesia - etiology</subject><subject>Hypesthesia - surgery</subject><subject>Leg</subject><subject>Lumbar Vertebrae</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Recovery of Function</subject><subject>Spinal Fusion</subject><subject>Spinal Stenosis - complications</subject><subject>Spinal Stenosis - surgery</subject><subject>Treatment Outcome</subject><issn>0949-2658</issn><issn>1436-2023</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1v1DAQhi0EotvCD-BS-cglwV_JxuJUVYUirdQLnC3XHq-8cuLUkyzaf1-XLRw5jTTzvK80DyGfOGs54_2XQ3vI2ArGty1TLWPqDdlwJftGMCHfkg3TSjei74YLcol4YBXsdPeeXIhBdb3s5IakGzqXjDO4JR6B4rL6E82BFnD5COVEQ8kjTbCn0zo-ToBIQ04p_47TnvoKjXOpy5gnimvZ_0nkQlOFbaE4x8mm2gpTxogfyLtgE8LH13lFfn27-3l73-wevv-4vdk1Tim5NNryrQXmuQKxtdz3ILdWeyccSCXrEVhwAbiQoWODY1JqrzpnbW-DhsHLK_L53Ftfe1oBFzNGdJCSnSCvaPigpe57qUVF-Rl11QIWCGYucbTlZDgzL5LNwVTJ5kWyYcpUyTVz_Vq_Po7g_yX-Wq3A1zMA9cljhGLQRZgc-Fi9Lsbn-J_6Z96rkFc</recordid><startdate>201707</startdate><enddate>201707</enddate><creator>Oba, Hiroki</creator><creator>Tsutsumimoto, Takahiro</creator><creator>Yui, Mutsuki</creator><creator>Kamanaka, Takayuki</creator><creator>Ohta, Hiroshi</creator><creator>Kosaku, Hidemi</creator><creator>Misawa, Hiromichi</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7087-3753</orcidid></search><sort><creationdate>201707</creationdate><title>A prospective study of recovery from leg numbness following decompression surgery for lumbar spinal stenosis</title><author>Oba, Hiroki ; Tsutsumimoto, Takahiro ; Yui, Mutsuki ; Kamanaka, Takayuki ; Ohta, Hiroshi ; Kosaku, Hidemi ; Misawa, Hiromichi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c443t-9a17ae0d14e27a1d6e37a9dc2ce343a17e0fcfe123f508c0339d45caa6af9e8d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Decompression, Surgical</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Hypesthesia - etiology</topic><topic>Hypesthesia - surgery</topic><topic>Leg</topic><topic>Lumbar Vertebrae</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Recovery of Function</topic><topic>Spinal Fusion</topic><topic>Spinal Stenosis - complications</topic><topic>Spinal Stenosis - surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Oba, Hiroki</creatorcontrib><creatorcontrib>Tsutsumimoto, Takahiro</creatorcontrib><creatorcontrib>Yui, Mutsuki</creatorcontrib><creatorcontrib>Kamanaka, Takayuki</creatorcontrib><creatorcontrib>Ohta, Hiroshi</creatorcontrib><creatorcontrib>Kosaku, Hidemi</creatorcontrib><creatorcontrib>Misawa, Hiromichi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Oba, Hiroki</au><au>Tsutsumimoto, Takahiro</au><au>Yui, Mutsuki</au><au>Kamanaka, Takayuki</au><au>Ohta, Hiroshi</au><au>Kosaku, Hidemi</au><au>Misawa, Hiromichi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A prospective study of recovery from leg numbness following decompression surgery for lumbar spinal stenosis</atitle><jtitle>Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association</jtitle><addtitle>J Orthop Sci</addtitle><date>2017-07</date><risdate>2017</risdate><volume>22</volume><issue>4</issue><spage>670</spage><epage>675</epage><pages>670-675</pages><issn>0949-2658</issn><eissn>1436-2023</eissn><abstract>Residual leg numbness (LN) following lumbar surgery can lower patient satisfaction; however, prospective studies are sparse. The purpose of this study was to evaluate recovery from LN following decompression surgery for lumbar spinal stenosis (LSS).
A total of 145 patients with LSS were enrolled. All patients underwent decompressive surgery, with or without spinal fusion, followed by a 12 month prospective follow-up. The degree of LN and leg pain (LP) was assessed using the visual analog scale (VAS), a patient-reported outcome measure.
Six patients dropped out, and we evaluated 139 patients (average age, 68.1 years). The average VAS-LN scores were 5.9 ± 2.6, 1.8 ± 2.3, 2.0 ± 2.5, 2.1 ± 2.6, 2.2 ± 2.5, and 2.1 ± 2.6, and the average VAS-LP scores were 5.7 ± 2.8, 1.2 ± 1.7, 0.9 ± 1.5, 1.4 ± 2.0, 1.4 ± 2.0, and 1.4 ± 1.9 preoperatively and at 2 weeks, 3, 6, 9, 12 months following the surgery, respectively. Significant improvement in VAS-LN and VAS-LP scores was observed during the first 2 weeks after the surgery. At 12 months after the surgery, the VAS-LN score was significantly greater than the VAS-LP score. The change in the VAS-LN score between the preoperative and 12 month-postoperative values was significantly smaller than that in the VAS-LP score. Multivariate logistic analyses revealed that preoperative symptom duration and preoperative dural sac cross-sectional area (DCSA) were the significant independent predictive factors for residual LN.
Following lumbar decompression surgery, LN improved significantly during the first 2 weeks after surgery. However, the improvement in the VAS-LN score was less than in the VAS-LP score. Patients with longer preoperative symptom duration and narrow preoperative DCSA showed less LN improvement.
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| ispartof | Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association, 2017-07, Vol.22 (4), p.670-675 |
| issn | 0949-2658 1436-2023 |
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| subjects | Aged Decompression, Surgical Female Follow-Up Studies Humans Hypesthesia - etiology Hypesthesia - surgery Leg Lumbar Vertebrae Male Middle Aged Prospective Studies Recovery of Function Spinal Fusion Spinal Stenosis - complications Spinal Stenosis - surgery Treatment Outcome |
| title | A prospective study of recovery from leg numbness following decompression surgery for lumbar spinal stenosis |
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