PMID- 32409888
OWN - NLM
STAT- MEDLINE
DCOM- 20210611
LR  - 20210611
IS  - 1432-0932 (Electronic)
IS  - 0940-6719 (Linking)
VI  - 29
IP  - 9
DP  - 2020 Sep
TI  - Two-year outcome comparison of decompression in 14 lipomatosis cases with 169 
      degenerative lumbar spinal stenosis cases: a Swiss prospective multicenter cohort 
      study.
PG  - 2243-2253
LID - 10.1007/s00586-020-06449-w [doi]
AB  - PURPOSE: Spinal epidural lipomatosis (SEL) is defined as an abnormal and 
      extensive accumulation of unencapsulated adipose tissue within the spinal 
      epidural space. To date, there is a lack of high-level evidence studies reporting 
      the outcome of surgical treatment of symptomatic SEL in patients with lumbar 
      spinal stenosis (LSS). The aim was to compare clinical outcomes in patients with 
      symptomatic LSS with and without SEL who underwent decompression surgery alone at 
      the 12- and 24-month follow-up. METHODS: One hundred and eighty-three patients 
      met the inclusion criteria, of which 14 had mainly SEL on at least one level 
      operated in addition to possible degenerative changes on other levels and 169 
      degenerative LSS only. The main outcomes were pain (Spinal Stenosis Measure (SSM) 
      symptoms), disability (SSM function), and quality of life [EQ-5D-3L summary index 
      (SI)] at 24-month follow-up, and minimal clinically important difference (MCID) 
      in SSM symptoms, SSM function, and EQ-5D-3L SI. RESULTS: The multiple regression 
      linear models showed that SEL was associated with worse SSM symptoms (p = 0.045) 
      and EQ-5D-3L SI scores (p = 0.026) at 24-month follow-up, but not with worse SSM 
      function scores. Further, depression (in all models) was negatively associated 
      with better clinical outcomes at 24-month follow-up. In the outcomes SSM symptoms 
      and EQ-5D-3L SI, distinctly more patients in the classical LSS group reached MCID 
      than in the SEL group (71.3% and 62.3% vs. 50.0% and 42.9%). CONCLUSIONS: Our 
      study demonstrated that decompression alone surgery was associated with 
      significant improvement in disability in both groups at 2 years, but not in pain 
      and quality of life in patients with SEL.
FAU - Ulrich, Nils H
AU  - Ulrich NH
AD  - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of 
      Zurich, Zurich, Switzerland. nils.ulrich@balgrist.ch.
AD  - University Spine Centre Zurich, Balgrist University Hospital, University of 
      Zurich, Zurich, Switzerland. nils.ulrich@balgrist.ch.
FAU - Gravestock, Isaac
AU  - Gravestock I
AD  - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of 
      Zurich, Zurich, Switzerland.
FAU - Winklhofer, Sebastian
AU  - Winklhofer S
AD  - Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, 
      University of Zurich, Zurich, Switzerland.
FAU - Peyneshki, Iliya
AU  - Peyneshki I
AD  - Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, 
      University of Zurich, Zurich, Switzerland.
FAU - Wertli, Maria M
AU  - Wertli MM
AD  - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of 
      Zurich, Zurich, Switzerland.
AD  - Division of General Internal Medicine, Bern University Hospital, Bern University, 
      Bern, Switzerland.
FAU - Pichierri, Giuseppe
AU  - Pichierri G
AD  - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of 
      Zurich, Zurich, Switzerland.
AD  - Institute for Primary Care, University and University Hospital Zurich, Zurich, 
      Switzerland.
FAU - Fekete, Tamas F
AU  - Fekete TF
AD  - Department of Orthopedics and Neurosurgery, Spine Center, Schulthess Clinic, 
      Zurich, Switzerland.
FAU - Porchet, Francois
AU  - Porchet F
AD  - Department of Orthopedics and Neurosurgery, Spine Center, Schulthess Clinic, 
      Zurich, Switzerland.
FAU - Farshad, Mazda
AU  - Farshad M
AD  - University Spine Centre Zurich, Balgrist University Hospital, University of 
      Zurich, Zurich, Switzerland.
FAU - Steurer, Johann
AU  - Steurer J
AD  - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of 
      Zurich, Zurich, Switzerland.
FAU - Burgstaller, Jakob M
AU  - Burgstaller JM
AD  - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of 
      Zurich, Zurich, Switzerland.
AD  - Institute for Primary Care, University and University Hospital Zurich, Zurich, 
      Switzerland.
CN  - LSOS Study Group
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20200514
PL  - Germany
TA  - Eur Spine J
JT  - European spine journal : official publication of the European Spine Society, the 
      European Spinal Deformity Society, and the European Section of the Cervical Spine 
      Research Society
JID - 9301980
SB  - IM
MH  - Decompression, Surgical
MH  - Humans
MH  - *Lipomatosis/surgery
MH  - Lumbar Vertebrae/surgery
MH  - Prospective Studies
MH  - Quality of Life
MH  - *Spinal Stenosis/surgery
MH  - Switzerland
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Lipomatosis
OT  - Lumbar spine
OT  - Spinal epidural lipomatosis
OT  - Stenosis
OT  - Surgical decompression
EDAT- 2020/05/16 06:00
MHDA- 2021/06/12 06:00
CRDT- 2020/05/16 06:00
PHST- 2020/01/22 00:00 [received]
PHST- 2020/05/02 00:00 [accepted]
PHST- 2020/04/09 00:00 [revised]
PHST- 2020/05/16 06:00 [pubmed]
PHST- 2021/06/12 06:00 [medline]
PHST- 2020/05/16 06:00 [entrez]
AID - 10.1007/s00586-020-06449-w [pii]
AID - 10.1007/s00586-020-06449-w [doi]
PST - ppublish
SO  - Eur Spine J. 2020 Sep;29(9):2243-2253. doi: 10.1007/s00586-020-06449-w. Epub 2020 
      May 14.