Departments of Clinical Sciences and Orthopaedics, Lund University, Skåne University Hospital, Malmö, Sweden.
Department of Orthopaedics, Varberg Hospital, Träslövsvägen 68, 432 37, Varberg, Sweden.
J Orthop Surg Res. 2024 Mar 25;19(1):200. doi: 10.1186/s13018-024-04614-1.
Detailed preoperative information is associated with superior outcomes. We aimed to describe the recovery pattern after decompression of central lumbar spinal stenosis (CLSS).
50 patients aged 51-85 years who underwent decompression without fusion due to CLSS were followed from before to after surgery (post-op day 1, 7, and 14). Back and leg pain were evaluated using the Numeric Rating Scale (NRS; 0 = no pain 0, 10 = worst pain) and quality of life using the EuroQol-5D index (0 = death, 1 = best), and EQ-5D-visual analogue scale (VAS; 0 = worst, 100 = best).
NRS leg pain was reduced from preoperative to first postoperative day by 5.2 (6.1, 4.3) (mean (95%CI)], and NRS back pain from postoperative day 1-7 by 0.6 (1.2, 0.03) and from day 7 to 14 by 0.7 (1.3, 0.2)]. In contrast, EQ-5D index increased from preoperative to first postoperative day by 0.09 (0.06, 0.13) and from day 1 to 7 by 0.05 (0.02,0.08), and EQ-5D VAS from preoperative to first postoperative day by 13.7 (9.1, 18.3) and from day 1 to 7 by 6.0 (2.0, 10.0). After two weeks, 51% of the patients had improved above the minimal clinically important difference (MCID) in back pain and 71% in leg pain.
Patients scheduled for decompression due to CLSS should be informed that improvement in leg pain and quality of life in general can be expected within one day of surgery, that quality of life improves a little further in the first postoperative week, and that back pain improves in the first 2 postoperative weeks. In most patients, decompression without fusion due to CLSS seems to achieve clinically relevant improvement within 2 weeks.
详细的术前信息与更好的结果相关。我们旨在描述中央腰椎椎管狭窄症（CLSS）减压后的恢复模式。
50 名年龄在 51-85 岁之间的患者因 CLSS 接受减压而未融合，从术前到术后（术后第 1、7 和 14 天）进行随访。使用数字评分量表（NRS；0=无痛，10=最痛）评估腰背疼痛，使用 EuroQol-5D 指数（0=死亡，1=最佳）评估生活质量，使用 EQ-5D 视觉模拟量表（0=最差，100=最佳）。
NRS 腿痛从术前到术后第 1 天减轻 5.2（6.1，4.3）（平均值（95%CI）），NRS 腰痛从术后第 1 天到第 7 天减轻 0.6（1.2，0.03），从术后第 7 天到第 14 天减轻 0.7（1.3，0.2）。相比之下，EQ-5D 指数从术前到术后第 1 天增加 0.09（0.06，0.13），从术后第 1 天到第 7 天增加 0.05（0.02，0.08），EQ-5D VAS 从术前到术后第 1 天增加 13.7（9.1，18.3），从术后第 1 天到第 7 天增加 6.0（2.0，10.0）。两周后，51%的患者背痛改善超过最小临床重要差异（MCID），71%的患者腿痛改善超过 MCID。
因 CLSS 接受减压手术的患者应被告知，术后一天内可预期腿痛和生活质量普遍改善，术后第一周生活质量进一步改善，背痛在术后两周内改善。在大多数患者中，因 CLSS 进行的减压而不融合似乎在 2 周内达到临床相关的改善。
