The influence of the lumbar spinal stenosis severity and extent on clinical symptoms and functional outcomes of surgical treatment
Objective. To evaluate the influence of the grade and extent of lumbar spinal stenosis on the severity of clinical symptoms before surgical treatment and the functional status of patients after surgery. Material and Methods. A retrospective monocentric study was conducted including 380 patients wi...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Ministry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan"
2025-03-01
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| Series: | Хирургия позвоночника |
| Subjects: | |
| Online Access: | https://www.spinesurgery.ru/jour/article/view/2229/2212 |
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| Summary: | Objective. To evaluate the influence of the grade and extent of lumbar spinal stenosis on the severity of clinical symptoms before surgical
treatment and the functional status of patients after surgery.
Material and Methods. A retrospective monocentric study was conducted including 380 patients with clinically significant degenerative
central lumbar stenosis. The grade of spinal canal stenosis was determined using MRI data (according to the Schizas and Lee – Guen
classifications). The number of affected spinal segments was also studied. The functional status before and after surgery was assessed using the ODI questionnaire, and pain – using the VAS. The dynamics of clinical changes after surgery was followed-up in 76 patients from
the general cohort who agreed to participate in a survey or came for a follow-up examination.
Results. After comparing the Oswestry and VAS scores in groups of patients with different grades of Schizas and Lee – Guen stenosis
severity, no statistically significant differences were noted (p = 0.325, p = 0.498, and p = 0.634, respectively). Statistically significant
differences in the number of affected segments were also not revealed (p = 0.281 for Oswestry and p = 0.664 for VAS). When assessing
the correlation between the extent of stenosis and questionnaire scores, a weak direct relationship was found between Oswestry scores
after surgery and the number of affected segments (rho = 0.357, p = 0.015). Construction of linear regression revealed that patients
with one and two affected segments vary significantly in outcomes (p = 0.039, 95 % CI [0.734; 2.65]), while other cases showed no statistically significant difference.
Conclusion. The conducted study showed no statistically significant relationship between the severity of lumbar stenosis, as assessed
according to the Schizas and Lee – Guen classifications, the number of affected segments and clinical symptoms in patients. It was also
found that the severity of the stenosis does not affect the outcome of surgery, while the functional outcomes after surgery for patients
with one or two affected segments may differ significantly in terms of statistics. |
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| ISSN: | 1810-8997 2313-1497 |