J Korean Soc Spine Surg.  2001 Mar;8(1):21-26.

Surgical Outcome of Degenerative Spinal Stenosis Clinical: Clinical Correlation of Patient Satisfaction and Surgical Results

• Han JH
• Cho JL
• Park YS
• Kang CN
• Choi YH

Abstract

STUDY DESIGN: This study is a retrospective evaluation of the surgical outcome by the patient satisfaction and Oswestry low back pain questionnaire.
OBJECTIVE
The goal of this study was to evaluate the clinical correlations of various factors with the patient's satisfaction and with the surgical results in degenerative spinal stenosis. SUMMARY OF LITERATURE REVIEW: The patients satisfaction and surgical outcome of the degenerative spinal stenosis by the objective method have not been well described in the literature. MATERIAL AND METHODS: Mean follow-up period was 4.8 years after surgery in 114 patients. Outcome was based on subjective disability using Oswestry low back pain questionnaire. Patient satisfaction degree was rated to 'very satisfied(1)', 'somewhat satisfied(2)', 'somewhat dissatisfied(3)' and 'very dissatisfied(4)'. Several factors that might be associated with patient satisfac-tion and outcome were investigated. RESULTS: Of the one hundred and fourteen patients, 84(73.9%) were satisfied to the surgery and mean satisfaction degree was 1.94. Ninety two patients(80.7%) had excellent-to-good results with the mean Oswestry disability score 26.9. There were 7 complications including dural tear in 3 cases, pseudarthrosis in 1 case, dissociation between rod and screw in 1 case, pedicle screw breakage in 1 case and termination of operatin due to massive bleeding during operation in 1 case.
CONCLUSION
Clinical results and patient satisfaction were better in the cases with short segments fusion than long segments fusion and the patients with preoperative leg symptom as major symptom had significantly lower Oswestry disability score.

Keyword

Lumbar spine; Degenerative spinal stenosis; Surgical outcome; Oswestry questionnaire; Satisfaction

MeSH Terms

Follow-Up Studies
Hemorrhage
Humans
Leg
Low Back Pain
Patient Satisfaction*
Pseudarthrosis
Surveys and Questionnaires
Retrospective Studies
Spinal Stenosis*

Reference

1). 김기수, 김엽, 김성택, 고재운, 최용수. 퇴행성 변화로 인한 범발성 요추관 협착증의 수 술적 치료. 대한정형외과학회지. 27:483–501. 1992.

2). 김남현, 강군순, 권순원, 강호정. 요추 척추관 협착증환자에대한 임상적고찰. 대한정형외과학회지. 20:573–582. 1985.

3). 박승림, 김명호, 김형수, 문경호, 임석원. 퇴행성 척추관 협착증의 임상적 고찰. 대한정형외과학회지. 26:1213–1218. 1991.

4). 심재익, 김택선, 이성종, 이석하, 유창무, 이동인. 요추부 척추관 협착증의수술적 치 료. 대한척추외과학회지. 3:49–60. 1996.

5). 조덕연, 김응하, 유병용, 양현모, 김영태. 척추관 협착증에 대한 수술적 치료. 대한정형외과학회지. 28:146–154. 1993.

6). 조재림, 윤원구, 권오재. 요추부 질환에서 시행한 단분절 유합과 장분절 유합간의 임상 결과에 대한 비교.대한척추외과학회지. 2:47–55. 1995.

7). Airaksinen O, Herno A, Turunen V, Saari T and Suomlainen O. Surgical outcome of 438 patients treated surgically for lumbar spinal stenosis. Spine. 22:2278–2282. 1997.

8). Blau JN and Logue V. The natural history of intermit -tent claudication of the cauda equina: A long term follow-up study. Brain. 101:211–222. 1978.

9). Echeverria T and Lockwood RC. Lumbar spinal stenosis, experience at a community hospital. New York J Med. 79:72–893. 1979.

10). Fairbank JCT, Mbaot JC, Davies JB and O'Brien JP. The Oswestry Low Back Pain Diability Questionnaire. Physiotherapy. 66:271–273. 1980.

11). Fast A, Robin GC and Flomer Y. Surgical treatment of lumbar spinal stenosis in the elderly. Arch Phys Med Rehabil. 66:149–151. 1985.

12). Grabias S. The treatment of spinal stenosis. Current con -cepts review. J Bone Joint Surg. 62A:308–313. 1980.

13). Greenough CG, Peterson MD, Hadlow S and Fraser RD. Instrumented posterlateral lumbar fusion: Results and comparison with anterior interbody fusion. Spine. 23:479–486. 1998.

14). Herkowitz HN and Garfin SR. Decompressive surgery for spinal stenosis. Seminars in Spine Surgery. 1:163–167. 1989.

15). Herno A, Airaksinen O and Saari T. Long-term results of surgical treatment of lumbar spinal stenosis. Spine. 18:471–1474. 1993.

16). Herno A, Airaksinen O, Saari T and Sihvonen T. Su rgical results of lumbar spinal stenosis. Spine. 20:964–969. 1995.

17). Herron L and Magelsdorf C. Lumbar spinal stenosis: Results of surgical treatment. J Spinal Disorders. 4:26–33. 1991.

18). Johnsson KE, Rosen I and Uden A. The natural course of lumbar spinal stenosis. Clin Orthop. 279:82–86. 1992.

19). Johnsson KE, Willner S and Pettersson H. Analysis of operated cases with lumbar spinal stenosis. Acta Orthop Scand. 52:427–433. 1981.

20). Johnsson KE, Willner W and Johnsson K. Postoperative instability after decompression for lumbar spinal stenosis. Spine. 11:107–119. 1986.

21). Katz JN, Lipson SJ, Chang LC, Levine SA, Fossel AH and Liang MH. Seven-to 10-year outcome of decompressive surgery for degenerative lumbar spinal stenosis. Spine. 21:2–98. 1996.

22). Katz JN, Lipson SJ and Brick GW, et al. Clinical cor -relates of patient satisfaction after laminectomy for degenerative lumbar stenosis. Spine. 20:1155–1160. 1995.

23). Macnab I and McCullock J. Backache. Baltimore: Williams & Wilkins;p. 163–167. 363-391. 1990.

24). Nasca RJ. Surgical management of lumbar spinal stenosis. Spine. 12:809–816. 1987.

25). Rompe JD, Eysel P and Hopf C. Clinical efficacy of pedicle instrumentation and posterolateral fusion in the symptomatic degenerative lumbar spine. Eur Spine J. 4:231–237. 1995.

26). Simpson JM, Silveri CP, Balderston RA, Simeone FA and An HS. The results of operation on the lumbar spine in patients who have diabetes mellitus. J Bone Joint Surg. 75-A:1823–1829. 1993.

27). Surin V, Hedelin E and Smith L. Degenerative lumbar spinal stenosis, results of operative treatment. Acta Orthop Scand. 53:79–85. 1982.

28). Turner JA, Ersek M, Herron L and Deyo R. Surgery for lumbar spinal stenosis: Attempted metaanalysis of the literature, Spine. 17:1–8. 1992.

29). Wiltse LL, Kirkaldy-Willis WH and McIvor DWD. The treatment of spinal stenosis. Clin Orthop. 115:83–91. 1976.