Khalsa Amrit S, Eghbali Areian, Eastlack Robert K, Tran Stacie, Akbarnia Behrooz A, Ledesma Justin B, Mundis Gregory M
San Diego Spine Foundation, San Diego, CA, USA.
Scripps Clinic, La Jolla, CA, USA.
Global Spine J. 2019 Apr;9(2):150-154. doi: 10.1177/2192568218765986. Epub 2018 Jul 26.
Retrospective review of a single institution.
To determine if resting leg pain level is a predictor of success for indirect decompression in the setting of lumbar spinal stenosis, with lower levels of rest pain correlating with greater likelihood of successful indirect decompression.
Reviewed anterior or lateral lumbar interbody fusions from T12 to L5-S1 patients with a posterior-based pedicle screw-rod construct. Patients were separated into 2 groups based on a preoperative response to Oswestry Disability Index (ODI) Question 7 regarding level of pain at rest in the supine position. Responses of 0 to 2 (minimal rest pain) were group 1 (n = 54) and responses of 3 to 5 (significant rest pain) were group 2 (n = 16).
Preoperative difference was detected between groups 1 and 2, in ODI (38 vs 63, < .001) and Numeric Rating Scale (NRS) back (6.8 vs 7.9, = .023). Three-month NRS leg and back scores were significantly lower in group 1 (leg, 1.9 vs 4.8, < .001; back, 3.5 vs 6.4, = .001). A significant difference was further noted in the percentage decrease in NRS leg and back scores from pre- to 3 months postoperatively between groups 1 and 2 (leg, 68.4% vs 22.7%, < .001; back, 40.0% vs 7.4%, = .012). Group 1 reached minimal clinically important difference for leg pain more often than group 2 (83.3% vs 43.8%, = .001).
Preoperative assessment of rest pain level in the supine position has a significant association with reduction in NRS leg and back scores in patients undergoing indirect decompression for lumbar spinal stenosis. This tool may successfully indicate which patients will be candidates for indirect decompression with interbody fusion from an anterior or lateral approach.
对单一机构进行回顾性研究。
确定静息腿痛程度是否为腰椎管狭窄症间接减压成功的预测指标，静息痛程度越低，间接减压成功的可能性越大。
回顾接受T12至L5-S1后路椎弓根螺钉-棒结构的前路或侧路腰椎椎间融合术的患者。根据术前对Oswestry功能障碍指数（ODI）第7个问题关于仰卧位静息痛程度的回答，将患者分为两组。回答为0至2（静息痛轻微）的为第1组（n = 54），回答为3至5（静息痛明显）的为第2组（n = 16）。
第1组和第2组之间术前在ODI（38对63，P <.001）和数字评定量表（NRS）背痛评分（6.8对7.9，P =.023）方面存在差异。第1组术后3个月的NRS腿痛和背痛评分显著更低（腿痛，1.9对4.8，P <.001；背痛，3.5对6.4，P =.001）。第1组和第2组术后3个月NRS腿痛和背痛评分较术前下降百分比进一步存在显著差异（腿痛，68.4%对22.7%，P <.001；背痛，40.0%对7.4%，P =.012）。第1组比第2组更常达到腿痛的最小临床重要差异（83.3%对43.8%，P =.001）。
术前评估仰卧位静息痛程度与接受腰椎管狭窄症间接减压患者的NRS腿痛和背痛评分降低显著相关。该工具可能成功表明哪些患者将成为前路或侧路椎间融合间接减压的候选者。
