Predictors of Reoperation after Microdecompression in Lumbar Spinal Stenosis

Hee-Jong Hwang; Hyung-Ki Park; Gwang-Soo Lee; June-Young Heo; Jae-Chil Chang

추천

검색

자료유형: 학술저널

저자정보: Hee-Jong Hwang (Department of Neurosurgery Soonchunhyang University College of Medicine Seoul Korea) Hyung-Ki Park (Department of Neurosurgery Soonchunhyang University College of Medicine Seoul Korea) Gwang-Soo Lee (Department of Neurosurgery Soonchunhyang University College of Medicine Seoul Korea) June-Young Heo (Department of Neurosurgery Soonchunhyang University College of Medicine Seoul Korea) Jae-Chil Chang (Department of Neurosurgery Soonchunhyang University College of Medicine Seoul Korea)

저널정보: 대한척추신경외과학회 Neurospine 대한척추신경외과학회지 제13권 제4호

발행연도: 2016.1

수록면: 183 - 189 (7page)

이용수

📌

연구주제

📖

연구배경

🔬

연구방법

🏆

연구결과

초록· 키워드

오류제보하기

Objective: The risk factors of reoperation after microdecompression (MD) for lumbar spinal stenosis (LSS) are unclear. In this study, we presented the outcomes of MD for degenerative LSS and investigated the risk factors associated with reoperation. Methods: A retrospective review was conducted using the clinical records and radiographs of patients with LSS who underwent MD. For clinical evaluation, we used the Japanese Orthopedic Association (JOA) scoring system for low back pain, body mass index, and Charlson comorbidity index. For radiological evaluation, disc height, facet angle, and sagittal rotation angle were measured in operated segments. Also the Modic change and Pfirrmann grade for degeneration in the endplate and disc were scored. Results: Forty-three patients aged 69±9 years at index surgery were followed for 48±25 months. The average preoperative JOA score was 6.9±1.6 points. The score improved to 9.1±2.1 points at the latest follow-up (p<0.001). Seven patients (16.3%) underwent reoperation. Clinical and radiological factors except operation level and Pfirrmann grade showed a p-value >0.1. Patients with Pfirrmann grade IV and lower lumbar segment had a 29.1% rate of reoperation (p=0.001), whereas patients without these factors had a 0% rate of reoperation. Conclusion: Moderate disk degeneration (Pfirrmann IV) in lower lumbar segments is a risk factor of disk herniation or foraminal stenosis requiring reoperation after MD in LSS.

참고문헌 (29)

참고문헌 신청

Alimi M / 2015 / Minimally invasive laminectomy for lumbar spinal stenosis in patients with and without preoperative spondylolisthesis: clinical outcome and reoperation rates / J Neurosurg Spine 22:339~352

Ball JR / 2011 / Youmans Neurological Surgery / Saunders :2752~2762

Banczerowski P / 2015 / Minimally invasive spine surgery: systematic review / Neurosurg Rev 38:11~26

Blumenthal C / 2013 / Radiographic predictors of delayed instability following decompression without fusion for degenerative grade I lumbar spondylolisthesis / J Neurosurg Spine 18:340~346

Burgstaller JM / 2015 / Arguments for the choice of surgical treatments in patients with lumbar spinal stenosis - a systematic appraisal of randomized controlled trials / BMC Musculoskelet Disord 16:96