| Autor: |
Thomas Degen, Karina Fischer, Robert Theiler, Stefan Schären, Otto W. Meyer, Guido Wanner, Patricia Chocano-Bedoya, Hans-Peter Simmen, Urs D. Schmid, Johann Steurer, Hannes B. Stähelin, Noemi Mantegazza, Heike A. Bischoff-Ferrari |
| Jazyk: |
angličtina |
| Rok vydání: |
2020 |
| Předmět: |
|
| Zdroj: |
Swiss Medical Weekly, Vol 150, Iss 3738 (2020) |
| Druh dokumentu: |
article |
| ISSN: |
1424-3997 |
| DOI: |
10.4414/smw.2020.20325 |
| Popis: |
AIMS OF THE STUDY Mobility disability due to spinal stenosis is common in the senior population and often surgery is warranted for patients with severe symptoms and neurological dysfunction. However, although current clinical guidelines recommend stabilisation surgery in addition to decompression in patients with spinal stenosis and instability due to degenerative spondylolisthesis, the relationship between outcomes and the specific type of surgery have not been well studied. We therefore assessed the postoperative recovery timeline for 12 months and compared patient-reported outcomes dependent on the extent of decompression and additional stabilisation among seniors undergoing spinal stenosis surgery. METHODS We investigated 457 patients (mean age 76.0 ± 10.7 years, 58% women) from a consecutive cohort prior to spinal stenosis surgery. Follow-up was at 3 or 6months and at 12 months postoperatively. At each visit, pain, neurological dysfunction and disability were assessed using the North American Spine Society questionnaire. Repeated-measures analysis compared outcomes by type of surgery adjusting for baseline symptoms, gender, age, number of comorbidities, centre and year of surgery. RESULTS Most improvement occurred within the first 3 to 6 months with little or no further improvement at 12 months. Over 12 months and in adjusted models, patients receiving one-segment versus multi-segment decompression experienced significantly greater reduction of pain (−49.2% vs −41.9%, p = 0.013) and neurological dysfunction (−37.1% vs −25.9%, p |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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