Skip to main content

22.02.2019 | Original Article

Improvements in Back and Leg Pain After Minimally Invasive Lumbar Decompression

verfasst von: Dustin H. Massel, MD, Benjamin C. Mayo, MD, Dil V. Patel, BS, Daniel D. Bohl, MD, MPH, Philip K. Louie, MD, Gregory D. Lopez, MD, Kern Singh, MD

Erschienen in: HSS Journal ®

Einloggen, um Zugang zu erhalten

Abstract

Background

Few studies have quantified clinical improvement following minimally invasive lumbar decompression based on predominant back pain or leg pain.

Purpose

To quantify improvement in patient-reported outcomes following minimally invasive lumbar decompression and determine the degree of improvement in back pain, leg pain, and disability in patients who present with predominant back pain or predominant leg pain.

Methods

Patients who underwent primary, one-level minimally invasive lumbar decompression for degenerative pathology were retrospectively reviewed. Comparisons of visual analog scale (VAS) back and leg pain scores, Oswestry Disability Index (ODI) scores, and Short Form-12 (SF-12) mental and physical component scores from pre-operative to 6-week, 12-week, 6-month, and 1-year follow-up. Subgroup analyses were performed for patients with predominant back pain or predominant leg pain.

Results

A total of 102 patients were identified. Scores on VAS back and leg pain, ODI, and SF-12 physical component improved from pre-operative to all post-operative time points. After 1 year, patients reported a 2.8-point (47%) reduction in back pain and a 4-point (61.1%) reduction in leg pain scores; 52 patients with predominant back pain and 50 patients with predominant leg pain reported reductions in pain throughout the year following surgery. In both the back and leg pain cohorts, patients experienced reductions in ODI during the first 6 months and throughout 1-year follow-up, respectively. The majority of patients achieved minimum clinically important difference, regardless of predominant symptom.

Conclusions

Patients reported improvements in back and leg pain following minimally invasive lumbar decompression regardless of predominant presenting symptom; however, patients with predominant leg pain may experience greater improvement than those with predominant back pain.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Ang CL, Phak-Boon Tow B, et al. Minimally invasive compared with open lumbar laminotomy: no functional benefits at 6 or 24 months after surgery. Spine J. 2015;15:1705–1712.CrossRef Ang CL, Phak-Boon Tow B, et al. Minimally invasive compared with open lumbar laminotomy: no functional benefits at 6 or 24 months after surgery. Spine J. 2015;15:1705–1712.CrossRef
2.
Zurück zum Zitat Atlas SJ, Deyo RA, Keller RB, et al. The Maine Lumbar Spine Study, Part III. 1-year outcomes of surgical and nonsurgical management of lumbar spinal stenosis. Spine (Phila Pa 1976). 1996;21:1787–1794. Atlas SJ, Deyo RA, Keller RB, et al. The Maine Lumbar Spine Study, Part III. 1-year outcomes of surgical and nonsurgical management of lumbar spinal stenosis. Spine (Phila Pa 1976). 1996;21:1787–1794.
3.
Zurück zum Zitat Atlas SJ, Keller RB, Robson D, Deyo RA, Singer DE. Surgical and nonsurgical management of lumbar spinal stenosis: four-year outcomes from the maine lumbar spine study. Spine (Phila Pa 1976). 2000;25:556–562. Atlas SJ, Keller RB, Robson D, Deyo RA, Singer DE. Surgical and nonsurgical management of lumbar spinal stenosis: four-year outcomes from the maine lumbar spine study. Spine (Phila Pa 1976). 2000;25:556–562.
4.
Zurück zum Zitat Auffinger BM, Lall RR, Dahdaleh NS, et al. Measuring surgical outcomes in cervical spondylotic myelopathy patients undergoing anterior cervical discectomy and fusion: assessment of minimum clinically important difference. PLoS One. 2013;8:e67408.CrossRef Auffinger BM, Lall RR, Dahdaleh NS, et al. Measuring surgical outcomes in cervical spondylotic myelopathy patients undergoing anterior cervical discectomy and fusion: assessment of minimum clinically important difference. PLoS One. 2013;8:e67408.CrossRef
5.
Zurück zum Zitat Borg-Stein J, Elson L, Brand E. The aging spine in sports. Clin Sports Med. 2012;31:473–486.CrossRef Borg-Stein J, Elson L, Brand E. The aging spine in sports. Clin Sports Med. 2012;31:473–486.CrossRef
6.
Zurück zum Zitat Burton AK, Clarke RD, McClune TD, Tillotson KM. The natural history of low back pain in adolescents. Spine (Phila Pa 1976). 1996;21:2323–2328. Burton AK, Clarke RD, McClune TD, Tillotson KM. The natural history of low back pain in adolescents. Spine (Phila Pa 1976). 1996;21:2323–2328.
7.
Zurück zum Zitat Carreon LY, Bratcher KR, Canan CE, Burke LO, Djurasovic M, Glassman SD. Differentiating minimum clinically important difference for primary and revision lumbar fusion surgeries. J Neurosurg Spine. 2013;18:102–106.CrossRef Carreon LY, Bratcher KR, Canan CE, Burke LO, Djurasovic M, Glassman SD. Differentiating minimum clinically important difference for primary and revision lumbar fusion surgeries. J Neurosurg Spine. 2013;18:102–106.CrossRef
8.
Zurück zum Zitat Carreon LY, Glassman SD, Campbell MJ, Anderson PA. Neck Disability Index, short form-36 physical component summary, and pain scales for neck and arm pain: the minimum clinically important difference and substantial clinical benefit after cervical spine fusion. Spine J. 2010;10:469–474.CrossRef Carreon LY, Glassman SD, Campbell MJ, Anderson PA. Neck Disability Index, short form-36 physical component summary, and pain scales for neck and arm pain: the minimum clinically important difference and substantial clinical benefit after cervical spine fusion. Spine J. 2010;10:469–474.CrossRef
9.
Zurück zum Zitat Choi KC, Kim JS, Kang BU, Lee CD, Lee SH. Changes in back pain after percutaneous endoscopic lumbar discectomy and annuloplasty for lumbar disc herniation: a prospective study. Pain Med. 2011;12:1615–1621.CrossRef Choi KC, Kim JS, Kang BU, Lee CD, Lee SH. Changes in back pain after percutaneous endoscopic lumbar discectomy and annuloplasty for lumbar disc herniation: a prospective study. Pain Med. 2011;12:1615–1621.CrossRef
10.
Zurück zum Zitat Cook CE, Frempong-Boadu AK, Radcliff K, Karikari I, Isaacs R. Older age and leg pain are good predictors of pain and disability outcomes in 2710 patients who receive lumbar fusion. HSS J. 2015;11:209215.CrossRef Cook CE, Frempong-Boadu AK, Radcliff K, Karikari I, Isaacs R. Older age and leg pain are good predictors of pain and disability outcomes in 2710 patients who receive lumbar fusion. HSS J. 2015;11:209215.CrossRef
11.
Zurück zum Zitat Copay AG, Glassman SD, Subach BR, Berven S, Schuler TC, Carreon LY. Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales. Spine J. 2008;8:968–974. Copay AG, Glassman SD, Subach BR, Berven S, Schuler TC, Carreon LY. Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales. Spine J. 2008;8:968–974.
12.
Zurück zum Zitat Eloqayli H, Al-omari M: Percutaneous discectomy: minimally invasive method for treatment of recurrent lumbar disc herniation. Clin Neurol Neurosurg. 2012;114:871–875.CrossRef Eloqayli H, Al-omari M: Percutaneous discectomy: minimally invasive method for treatment of recurrent lumbar disc herniation. Clin Neurol Neurosurg. 2012;114:871–875.CrossRef
13.
Zurück zum Zitat Fairbank JC, Pynsent PB: The Oswestry Disability Index. Spine (Phila Pa 1976). 2000;25:2940–2952. Fairbank JC, Pynsent PB: The Oswestry Disability Index. Spine (Phila Pa 1976). 2000;25:2940–2952.
14.
Zurück zum Zitat Fritz JM, Delitto A, Welch WC, Erhard RE. Lumbar spinal stenosis: a review of current concepts in evaluation, management, and outcome measurements. Arch Phys Med Rehabil. 1998;79:700–708. Fritz JM, Delitto A, Welch WC, Erhard RE. Lumbar spinal stenosis: a review of current concepts in evaluation, management, and outcome measurements. Arch Phys Med Rehabil. 1998;79:700–708.
15.
Zurück zum Zitat Gadjradj PS, van Tulder MW, Dirven CM, Peul WC, Harhangi BS. Clinical outcomes after percutaneous transforaminal endoscopic discectomy for lumbar disc herniation: a prospective case series. Neurosurg Focus. 2016;40:E3. Gadjradj PS, van Tulder MW, Dirven CM, Peul WC, Harhangi BS. Clinical outcomes after percutaneous transforaminal endoscopic discectomy for lumbar disc herniation: a prospective case series. Neurosurg Focus. 2016;40:E3.
16.
Zurück zum Zitat Gautschi OP, Corniola MV, Smoll NR, et al. Sex differences in subjective and objective measures of pain, functional impairment, and health-related quality of life in patients with lumbar degenerative disc disease. Pain. 2016;157:1065–1071.CrossRef Gautschi OP, Corniola MV, Smoll NR, et al. Sex differences in subjective and objective measures of pain, functional impairment, and health-related quality of life in patients with lumbar degenerative disc disease. Pain. 2016;157:1065–1071.CrossRef
17.
Zurück zum Zitat Gautschi OP, Smoll NR, Corniola MV, et al. Sex differences in lumbar degenerative disc disease. Clin Neurol Neurosurg. 2016;145:52–57.CrossRef Gautschi OP, Smoll NR, Corniola MV, et al. Sex differences in lumbar degenerative disc disease. Clin Neurol Neurosurg. 2016;145:52–57.CrossRef
18.
Zurück zum Zitat German JW, Adamo MA, Hoppenot RG, Blossom JH, Nagle HA. Perioperative results following lumbar discectomy: comparison of minimally invasive discectomy and standard microdiscectomy. Neurosurg Focus. 2008;25:E20.CrossRef German JW, Adamo MA, Hoppenot RG, Blossom JH, Nagle HA. Perioperative results following lumbar discectomy: comparison of minimally invasive discectomy and standard microdiscectomy. Neurosurg Focus. 2008;25:E20.CrossRef
19.
Zurück zum Zitat Hakkinen A, Kautiainen H, Jarvenpaa S, Arkela-Kautiainen M, Ylinen J. Changes in the total Oswestry Index and its ten items in females and males pre- and post-surgery for lumbar disc herniation: a 1-year follow-up. Eur Spine J.. 2007;16:347–352. Hakkinen A, Kautiainen H, Jarvenpaa S, Arkela-Kautiainen M, Ylinen J. Changes in the total Oswestry Index and its ten items in females and males pre- and post-surgery for lumbar disc herniation: a 1-year follow-up. Eur Spine J.. 2007;16:347–352.
20.
Zurück zum Zitat Huang P, Anissipour A, McGee W, Lemak L. Return-to-play recommendations after cervical, thoracic, and lumbar spine injuries: a comprehensive review. Sports Health. 2016;8:19–25.CrossRef Huang P, Anissipour A, McGee W, Lemak L. Return-to-play recommendations after cervical, thoracic, and lumbar spine injuries: a comprehensive review. Sports Health. 2016;8:19–25.CrossRef
21.
Zurück zum Zitat Jarvik JG, Deyo RA. Diagnostic evaluation of low back pain with emphasis on imaging. Ann Intern Med. 2002;137:586–597.CrossRef Jarvik JG, Deyo RA. Diagnostic evaluation of low back pain with emphasis on imaging. Ann Intern Med. 2002;137:586–597.CrossRef
22.
Zurück zum Zitat Khajavi K, Shen A, Hutchison A. Substantial clinical benefit of minimally invasive lateral interbody fusion for degenerative spondylolisthesis. Eur Spine J. 2015;24 Suppl 3:314–321. Khajavi K, Shen A, Hutchison A. Substantial clinical benefit of minimally invasive lateral interbody fusion for degenerative spondylolisthesis. Eur Spine J. 2015;24 Suppl 3:314–321.
23.
Zurück zum Zitat Khajavi K, Shen AY. Two-year radiographic and clinical outcomes of a minimally invasive, lateral, transpsoas approach for anterior lumbar interbody fusion in the treatment of adult degenerative scoliosis. Eur Spine J. 2014;23:1215–1223. Khajavi K, Shen AY. Two-year radiographic and clinical outcomes of a minimally invasive, lateral, transpsoas approach for anterior lumbar interbody fusion in the treatment of adult degenerative scoliosis. Eur Spine J. 2014;23:1215–1223.
24.
Zurück zum Zitat Kim HJ, Suh BG, Lee DB, et al. Gender difference of symptom severity in lumbar spinal stenosis: role of pain sensitivity. Pain Physician. 2013;16:E715–723.PubMed Kim HJ, Suh BG, Lee DB, et al. Gender difference of symptom severity in lumbar spinal stenosis: role of pain sensitivity. Pain Physician. 2013;16:E715–723.PubMed
25.
Zurück zum Zitat Kleinstuck FS, Grob D, Lattig F, et al. The influence of preoperative back pain on the outcome of lumbar decompression surgery. Spine (Phila Pa 1976). 2009;34:1198–1203. Kleinstuck FS, Grob D, Lattig F, et al. The influence of preoperative back pain on the outcome of lumbar decompression surgery. Spine (Phila Pa 1976). 2009;34:1198–1203.
26.
Zurück zum Zitat Konstantinou K, Dunn KM, Ogollah R, Vogel S, Hay EM, ATLAS study research team. Characteristics of patients with low back and leg pain seeking treatment in primary care: baseline results from the ATLAS cohort study. BMC Musculoskelet Disord. 2015;16:332. Konstantinou K, Dunn KM, Ogollah R, Vogel S, Hay EM, ATLAS study research team. Characteristics of patients with low back and leg pain seeking treatment in primary care: baseline results from the ATLAS cohort study. BMC Musculoskelet Disord. 2015;16:332.
27.
Zurück zum Zitat Lee P, Liu JC, Fessler RG. Perioperative results following open and minimally invasive single-level lumbar discectomy. J Clin Neurosci. 2011;18:1667–1670.CrossRef Lee P, Liu JC, Fessler RG. Perioperative results following open and minimally invasive single-level lumbar discectomy. J Clin Neurosci. 2011;18:1667–1670.CrossRef
28.
Zurück zum Zitat Majeed SA, Vikraman CS, Mathew V, Anish, TS. Comparison of outcomes between conventional lumbar fenestration discectomy and minimally invasive lumbar discectomy: an observational study with a minimum 2-year follow-up. J Orthop Surg Res. 2013;8:34.CrossRef Majeed SA, Vikraman CS, Mathew V, Anish, TS. Comparison of outcomes between conventional lumbar fenestration discectomy and minimally invasive lumbar discectomy: an observational study with a minimum 2-year follow-up. J Orthop Surg Res. 2013;8:34.CrossRef
29.
Zurück zum Zitat Mallen CD, Peat G, Thomas E, Dunn KM, Croft PR. Prognostic factors for musculoskeletal pain in primary care: a systematic review. Br J Gen Pract. 2007;57:655–661.PubMedPubMedCentral Mallen CD, Peat G, Thomas E, Dunn KM, Croft PR. Prognostic factors for musculoskeletal pain in primary care: a systematic review. Br J Gen Pract. 2007;57:655–661.PubMedPubMedCentral
30.
Zurück zum Zitat Mathews HH, Long BH. Minimally invasive techniques for the treatment of intervertebral disk herniation. J Am Acad Orthop Surg. 2002;10:80–85.CrossRef Mathews HH, Long BH. Minimally invasive techniques for the treatment of intervertebral disk herniation. J Am Acad Orthop Surg. 2002;10:80–85.CrossRef
31.
Zurück zum Zitat Meucci RD, Fassa AG, Faria NM. Prevalence of chronic low back pain: systematic review. Rev Saude Publica. 2015;49:1.CrossRef Meucci RD, Fassa AG, Faria NM. Prevalence of chronic low back pain: systematic review. Rev Saude Publica. 2015;49:1.CrossRef
32.
Zurück zum Zitat Ohtori S, Ito T, Yamashita M, et al. Evaluation of low back pain using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire for lumbar spinal disease in a multicenter study: differences in scores based on age, sex, and type of disease. J Orthop Sci. 2010;15:86–91. Ohtori S, Ito T, Yamashita M, et al. Evaluation of low back pain using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire for lumbar spinal disease in a multicenter study: differences in scores based on age, sex, and type of disease. J Orthop Sci. 2010;15:86–91.
33.
Zurück zum Zitat Olsen TL, Anderson RL, Dearwater SR, et al. The epidemiology of low back pain in an adolescent population. Am J Public Health. 1992;82:606–608.CrossRef Olsen TL, Anderson RL, Dearwater SR, et al. The epidemiology of low back pain in an adolescent population. Am J Public Health. 1992;82:606–608.CrossRef
34.
Zurück zum Zitat Parker SL, Adogwa O, Mendenhall SK, et al. Determination of minimum clinically important difference (MCID) in pain, disability, and quality of life after revision fusion for symptomatic pseudoarthrosis. Spine J. 2012;12:1122–1128.CrossRef Parker SL, Adogwa O, Mendenhall SK, et al. Determination of minimum clinically important difference (MCID) in pain, disability, and quality of life after revision fusion for symptomatic pseudoarthrosis. Spine J. 2012;12:1122–1128.CrossRef
35.
Zurück zum Zitat Parker SL, Adogwa O, Paul AR, et al. Utility of minimum clinically important difference in assessing pain, disability, and health state after transforaminal lumbar interbody fusion for degenerative lumbar spondylolisthesis. J Neurosurg Spine. 2011;14:598–604.CrossRef Parker SL, Adogwa O, Paul AR, et al. Utility of minimum clinically important difference in assessing pain, disability, and health state after transforaminal lumbar interbody fusion for degenerative lumbar spondylolisthesis. J Neurosurg Spine. 2011;14:598–604.CrossRef
36.
Zurück zum Zitat Parker SL, Godil SS, Mendenhall SK, Zuckerman SL, Shau DN, McGirt MJ. Two-year comprehensive medical management of degenerative lumbar spine disease (lumbar spondylolisthesis, stenosis, or disc herniation): a value analysis of cost, pain, disability, and quality of life: clinical article. J Neurosurg Spine. 2014;21:143–149.CrossRef Parker SL, Godil SS, Mendenhall SK, Zuckerman SL, Shau DN, McGirt MJ. Two-year comprehensive medical management of degenerative lumbar spine disease (lumbar spondylolisthesis, stenosis, or disc herniation): a value analysis of cost, pain, disability, and quality of life: clinical article. J Neurosurg Spine. 2014;21:143–149.CrossRef
37.
Zurück zum Zitat Parker SL, Godil SS, Shau DN, Mendenhall SK, McGirt MJ. Assessment of the minimum clinically important difference in pain, disability, and quality of life after anterior cervical discectomy and fusion: clinical article. J Neurosurg Spine. 2013;18:154–160,CrossRef Parker SL, Godil SS, Shau DN, Mendenhall SK, McGirt MJ. Assessment of the minimum clinically important difference in pain, disability, and quality of life after anterior cervical discectomy and fusion: clinical article. J Neurosurg Spine. 2013;18:154–160,CrossRef
38.
Zurück zum Zitat Parker SL, Mendenhall SK, Shau DN, et al. Minimum clinically important difference in pain, disability, and quality of life after neural decompression and fusion for same-level recurrent lumbar stenosis: understanding clinical versus statistical significance. J Neurosurg Spine. 2012;16:471–478.CrossRef Parker SL, Mendenhall SK, Shau DN, et al. Minimum clinically important difference in pain, disability, and quality of life after neural decompression and fusion for same-level recurrent lumbar stenosis: understanding clinical versus statistical significance. J Neurosurg Spine. 2012;16:471–478.CrossRef
39.
Zurück zum Zitat Pearson A, Blood E, Lurie J, et al. Predominant leg pain is associated with better surgical outcomes in degenerative spondylolisthesis and spinal stenosis: results from the Spine Patient Outcomes Research Trial (SPORT). Spine (Phila Pa 1976). 2011;36:219–229. Pearson A, Blood E, Lurie J, et al. Predominant leg pain is associated with better surgical outcomes in degenerative spondylolisthesis and spinal stenosis: results from the Spine Patient Outcomes Research Trial (SPORT). Spine (Phila Pa 1976). 2011;36:219–229.
40.
Zurück zum Zitat Phan K, Mobbs RJ. Minimally invasive versus open laminectomy for lumbar stenosis: a systematic review and meta-analysis. Spine (Phila Pa 1976). 2016;41:E91–E100. Phan K, Mobbs RJ. Minimally invasive versus open laminectomy for lumbar stenosis: a systematic review and meta-analysis. Spine (Phila Pa 1976). 2016;41:E91–E100.
41.
Zurück zum Zitat Phan K, Thayaparan GK, Mobbs RJ. Anterior lumbar interbody fusion versus transforaminal lumbar interbody fusion—systematic review and meta-analysis. Br J Neurosurg. 2015;29:705–711.CrossRef Phan K, Thayaparan GK, Mobbs RJ. Anterior lumbar interbody fusion versus transforaminal lumbar interbody fusion—systematic review and meta-analysis. Br J Neurosurg. 2015;29:705–711.CrossRef
42.
Zurück zum Zitat Pool JJ, Ostelo RW, Hoving JL, Bouter LM, de Vet HC. Minimal clinically important change of the Neck Disability Index and the Numerical Rating Scale for patients with neck pain. Spine (Phila Pa 1976). 2007;32:3047–3051. Pool JJ, Ostelo RW, Hoving JL, Bouter LM, de Vet HC. Minimal clinically important change of the Neck Disability Index and the Numerical Rating Scale for patients with neck pain. Spine (Phila Pa 1976). 2007;32:3047–3051.
43.
Zurück zum Zitat Rao PJ, Loganathan A, Yeung V, Mobbs RJ. Outcomes of anterior lumbar interbody fusion surgery based on indication: a prospective study. Neurosurgery. 2015;76:7–23.CrossRef Rao PJ, Loganathan A, Yeung V, Mobbs RJ. Outcomes of anterior lumbar interbody fusion surgery based on indication: a prospective study. Neurosurgery. 2015;76:7–23.CrossRef
44.
Zurück zum Zitat Rasouli MR, Rahimi-Movaghar V, Shokraneh F, Moradi-Lakeh M, Chou R. Minimally invasive discectomy versus microdiscectomy/open discectomy for symptomatic lumbar disc herniation. Cochrane Database Syst Rev. 2014;CD010328. Rasouli MR, Rahimi-Movaghar V, Shokraneh F, Moradi-Lakeh M, Chou R. Minimally invasive discectomy versus microdiscectomy/open discectomy for symptomatic lumbar disc herniation. Cochrane Database Syst Rev. 2014;CD010328.
45.
Zurück zum Zitat Scheer JK, Mundis GM, Klineberg E, et al. Postoperative recovery after adult spinal deformity surgery: comparative analysis of age in 149 patients during 2-year follow-up. Spine (Phila Pa 1976). 2015;40:1505–1515. Scheer JK, Mundis GM, Klineberg E, et al. Postoperative recovery after adult spinal deformity surgery: comparative analysis of age in 149 patients during 2-year follow-up. Spine (Phila Pa 1976). 2015;40:1505–1515.
46.
Zurück zum Zitat Scheer JK, Smith JS, Clark AJ, et al. Comprehensive study of back and leg pain improvements after adult spinal deformity surgery: analysis of 421 patients with 2-year follow-up and of the impact of the surgery on treatment satisfaction. J Neurosurg Spine. 2015;22:540–553.CrossRef Scheer JK, Smith JS, Clark AJ, et al. Comprehensive study of back and leg pain improvements after adult spinal deformity surgery: analysis of 421 patients with 2-year follow-up and of the impact of the surgery on treatment satisfaction. J Neurosurg Spine. 2015;22:540–553.CrossRef
47.
Zurück zum Zitat Sigmundsson FG, Jonsson B, Stromqvist B. Outcome of decompression with and without fusion in spinal stenosis with degenerative spondylolisthesis in relation to preoperative pain pattern: a register study of 1,624 patients. Spine J. 2015;15:638–646.CrossRef Sigmundsson FG, Jonsson B, Stromqvist B. Outcome of decompression with and without fusion in spinal stenosis with degenerative spondylolisthesis in relation to preoperative pain pattern: a register study of 1,624 patients. Spine J. 2015;15:638–646.CrossRef
48.
Zurück zum Zitat Sobottke R, Herren C, Siewe J, Mannion AF, Roder C, Aghayev E. Predictors of improvement in quality of life and pain relief in lumbar spinal stenosis relative to patient age: a study based on the Spine Tango registry. Eur Spine J. 2017;26:462–472. Sobottke R, Herren C, Siewe J, Mannion AF, Roder C, Aghayev E. Predictors of improvement in quality of life and pain relief in lumbar spinal stenosis relative to patient age: a study based on the Spine Tango registry. Eur Spine J. 2017;26:462–472.
49.
Zurück zum Zitat Stienen MN, Joswig H, Smoll NR, et al. Short- and long-term outcome of microscopic lumbar spine surgery in patients with predominant back or predominant leg pain. World Neurosurg. 2016;93:458–465.CrossRef Stienen MN, Joswig H, Smoll NR, et al. Short- and long-term outcome of microscopic lumbar spine surgery in patients with predominant back or predominant leg pain. World Neurosurg. 2016;93:458–465.CrossRef
50.
Zurück zum Zitat Than KD, Park P, Fu KM, et al. Clinical and radiographic parameters associated with best versus worst clinical outcomes in minimally invasive spinal deformity surgery. J Neurosurg Spine. 2016;25:21–25.CrossRef Than KD, Park P, Fu KM, et al. Clinical and radiographic parameters associated with best versus worst clinical outcomes in minimally invasive spinal deformity surgery. J Neurosurg Spine. 2016;25:21–25.CrossRef
51.
Zurück zum Zitat Vilagut G, Forero CG, Pinto-Meza A, et al: The mental component of the short-form 12 health survey (SF-12) as a measure of depressive disorders in the general population: results with three alternative scoring methods. Value Health. 2013;16:564–573.CrossRef Vilagut G, Forero CG, Pinto-Meza A, et al: The mental component of the short-form 12 health survey (SF-12) as a measure of depressive disorders in the general population: results with three alternative scoring methods. Value Health. 2013;16:564–573.CrossRef
52.
Zurück zum Zitat Ware J, Kosinski M, Keller SD. A 12-item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34:220–233.CrossRef Ware J, Kosinski M, Keller SD. A 12-item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34:220–233.CrossRef
Metadaten
Titel
Improvements in Back and Leg Pain After Minimally Invasive Lumbar Decompression
verfasst von
Dustin H. Massel, MD
Benjamin C. Mayo, MD
Dil V. Patel, BS
Daniel D. Bohl, MD, MPH
Philip K. Louie, MD
Gregory D. Lopez, MD
Kern Singh, MD
Publikationsdatum
22.02.2019
Verlag
Springer US
Erschienen in
HSS Journal ®
Print ISSN: 1556-3316
Elektronische ISSN: 1556-3324
DOI
https://doi.org/10.1007/s11420-018-09661-z

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.