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- Publisher Website: 10.1302/0301-620X.101B2.BJJ-2018-1136.R2
- Scopus: eid_2-s2.0-85060930483
- PMID: 30700115
- WOS: WOS:000459153000006
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Article: The influence of developmental spinal stenosis on the risk of re-operation on an adjacent segment after decompression-only surgery for lumbar spinal stenosis
Title | The influence of developmental spinal stenosis on the risk of re-operation on an adjacent segment after decompression-only surgery for lumbar spinal stenosis |
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Authors | |
Keywords | Developmental spinal stenosis ;;; Risk factor Reoperation Adjacent level Adjacent segment Lumbar surgery |
Issue Date | 2019 |
Publisher | British Editorial Society of Bone and Joint Surgery. The Journal's web site is located at http://www.bjj.boneandjoint.org.uk/ |
Citation | The Bone & Joint Journal, 2019, v. 101-B n. 2, p. 154-161 How to Cite? |
Abstract | Aims: The aim of this study was to determine the influence of developmental spinal stenosis (DSS) on the risk of re-operation at an adjacent level.
Patients and Methods: This was a retrospective study of 235 consecutive patients who had undergone decompression-only surgery for lumbar spinal stenosis and had a minimum five-year follow-up. There were 106 female patients (45.1%) and 129 male patients (54.9%), with a mean age at surgery of 66.8 years (sd 11.3). We excluded those with adult deformity and spondylolisthesis. Presenting symptoms, levels operated on initially and at re-operation were studied. MRI measurements included the anteroposterior diameter of the bony spinal canal, the degree of disc degeneration, and the thickness of the ligamentum flavum. DSS was defined by comparative measurements of the bony spinal canal. Risk factors for re-operation at the adjacent level were determined and included in a multivariate stepwise logistic regression for prediction modelling. Odds ratios (ORs) with 95% confidence intervals were calculated.
Results: Of the 235 patients, 21.7% required re-operation at an adjacent segment. Re-operation at an adjacent segment was associated with DSS (p = 0.026), the number of levels decompressed (p = 0.008), and age at surgery (p = 0.013). Multivariate regression model (p < 0.001) controlled for other confounders showed that DSS was a significant predictor of re-operation at an adjacent segment, with an adjusted OR of 3.93.
Conclusion: Patients with DSS who have undergone lumbar spinal decompression are 3.9 times more likely to undergo future surgery at an adjacent level. This is a poor prognostic indicator that can be identified prior to index decompression surgery. |
Persistent Identifier | http://hdl.handle.net/10722/268184 |
ISSN | 2023 Impact Factor: 4.9 2023 SCImago Journal Rankings: 2.280 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Cheung, WHP | - |
dc.contributor.author | Fong, HK | - |
dc.contributor.author | Wong, CS | - |
dc.contributor.author | Cheung, JPY | - |
dc.date.accessioned | 2019-03-18T04:20:18Z | - |
dc.date.available | 2019-03-18T04:20:18Z | - |
dc.date.issued | 2019 | - |
dc.identifier.citation | The Bone & Joint Journal, 2019, v. 101-B n. 2, p. 154-161 | - |
dc.identifier.issn | 2049-4394 | - |
dc.identifier.uri | http://hdl.handle.net/10722/268184 | - |
dc.description.abstract | Aims: The aim of this study was to determine the influence of developmental spinal stenosis (DSS) on the risk of re-operation at an adjacent level. Patients and Methods: This was a retrospective study of 235 consecutive patients who had undergone decompression-only surgery for lumbar spinal stenosis and had a minimum five-year follow-up. There were 106 female patients (45.1%) and 129 male patients (54.9%), with a mean age at surgery of 66.8 years (sd 11.3). We excluded those with adult deformity and spondylolisthesis. Presenting symptoms, levels operated on initially and at re-operation were studied. MRI measurements included the anteroposterior diameter of the bony spinal canal, the degree of disc degeneration, and the thickness of the ligamentum flavum. DSS was defined by comparative measurements of the bony spinal canal. Risk factors for re-operation at the adjacent level were determined and included in a multivariate stepwise logistic regression for prediction modelling. Odds ratios (ORs) with 95% confidence intervals were calculated. Results: Of the 235 patients, 21.7% required re-operation at an adjacent segment. Re-operation at an adjacent segment was associated with DSS (p = 0.026), the number of levels decompressed (p = 0.008), and age at surgery (p = 0.013). Multivariate regression model (p < 0.001) controlled for other confounders showed that DSS was a significant predictor of re-operation at an adjacent segment, with an adjusted OR of 3.93. Conclusion: Patients with DSS who have undergone lumbar spinal decompression are 3.9 times more likely to undergo future surgery at an adjacent level. This is a poor prognostic indicator that can be identified prior to index decompression surgery. | - |
dc.language | eng | - |
dc.publisher | British Editorial Society of Bone and Joint Surgery. The Journal's web site is located at http://www.bjj.boneandjoint.org.uk/ | - |
dc.relation.ispartof | The Bone & Joint Journal | - |
dc.subject | Developmental spinal stenosis ;;; Risk factor | - |
dc.subject | Reoperation | - |
dc.subject | Adjacent level | - |
dc.subject | Adjacent segment | - |
dc.subject | Lumbar surgery | - |
dc.title | The influence of developmental spinal stenosis on the risk of re-operation on an adjacent segment after decompression-only surgery for lumbar spinal stenosis | - |
dc.type | Article | - |
dc.identifier.email | Cheung, WHP: gnuehcp6@hku.hk | - |
dc.identifier.email | Cheung, JPY: cheungjp@hku.hk | - |
dc.identifier.authority | Cheung, JPY=rp01685 | - |
dc.description.nature | postprint | - |
dc.identifier.doi | 10.1302/0301-620X.101B2.BJJ-2018-1136.R2 | - |
dc.identifier.pmid | 30700115 | - |
dc.identifier.scopus | eid_2-s2.0-85060930483 | - |
dc.identifier.hkuros | 297016 | - |
dc.identifier.volume | 101-B | - |
dc.identifier.issue | 2 | - |
dc.identifier.spage | 154 | - |
dc.identifier.epage | 161 | - |
dc.identifier.isi | WOS:000459153000006 | - |
dc.publisher.place | United Kingdom | - |
dc.identifier.issnl | 2049-4394 | - |