Graebsch Carolin, Buser Zorica, Leroy Sophie, Wang Jeffrey C, Yoon Tim, Bone Stefan, Meisel Hans Jörg, Schenk Philipp
Department of Science, Research and Education, BG Klinikum Bergmannstrost Halle, Halle, Germany.
Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Global Spine J. 2025 Jan 30:21925682251316557. doi: 10.1177/21925682251316557.
Multicenter, prospective observational cohort study.
109 patients with lumbar spine stenosis (LSS) undergoing minimally invasive decompression in 6 different centers (Germany, Italy, USA).
The demographic, surgical and clinical data was collected. Patients were examined preoperatively, immediately postoperatively, at 6 and 12 months after surgery with regard to pain (back and legs) and functional outcomes (ODI, SF-36, EQ5D).
The mean age of the cohort was 67 ± 11 years, with a BMI of 31.8 ± 6.6 kg/m². Most patients (93%) underwent single-level decompression, and postoperative adverse events occurred in 17% of cases. Significant initial reductions in back (6.0 ± 2.8 to 2.4 ± 2.1) and leg pain (6.4 ± 2.1 to 2.1 ± 2.5) were observed ( < 0.001). However, pain levels increased significantly by the 12-month period, reaching 3.9 ± 2.7 for back pain and 3.9 ± 2.4 for leg pain ( < 0.001). Functional scores (ODI) improved from 43 ± 18 at baseline to 36 ± 18 post-treatment but showed no further significant change ( = 0.509) by 12 months. Health status (EQ5D index) improved from 0.53 ± 0.33 to 0.82 ± 0.16 immediately post-treatment but declined to 0.75 ± 0.21 by 12 months ( = 0.011). SF36 physical scores also showed initial improvement but plateaued at follow-ups. Notably, high BMI and prior spine surgery were associated with worse outcomes.
Although minimally invasive decompression without fusion initially led to a significant improvement in patients with LSS, the results deteriorated significantly over the course of the observation period. Future studies should focus on strategies to ensure sustained improvement in symptoms in patients with lumbar stenosis undergoing decompression procedure.
多中心前瞻性观察队列研究。
109例腰椎管狭窄症（LSS）患者，在6个不同中心（德国、意大利、美国）接受微创减压手术。
收集人口统计学、手术及临床数据。在术前、术后即刻、术后6个月和12个月对患者进行疼痛（背部和腿部）及功能结局（ODI、SF - 36、EQ5D）检查。
该队列的平均年龄为67±11岁，体重指数为31.8±6.6kg/m²。大多数患者（93%）接受了单节段减压，17%的病例发生了术后不良事件。观察到背部疼痛（从6.0±2.8降至2.4±2.1）和腿部疼痛（从6.4±2.1降至2.1±2.5）在术后初期显著减轻（P<0.001）。然而，到12个月时疼痛水平显著增加，背痛达到3.9±2.7，腿痛达到3.9±2.4（P<0.001）。功能评分（ODI）从基线时的43±18改善至治疗后的36±18，但到12个月时无进一步显著变化（P = 0.509）。健康状况（EQ5D指数）在治疗后即刻从0.53±0.33改善至0.82±0.16，但到12个月时降至0.75±0.21（P = 0.011）。SF36身体评分在术后初期也有所改善，但在随访时趋于平稳。值得注意的是，高体重指数和既往脊柱手术与较差的结局相关。
尽管无融合的微创减压术最初使腰椎管狭窄症患者有显著改善，但在观察期内结果显著恶化。未来研究应聚焦于确保接受减压手术的腰椎管狭窄症患者症状持续改善的策略。
