PMID- 32675604
OWN - NLM
STAT- MEDLINE
DCOM- 20201103
LR  - 20210115
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 45
IP  - 15
DP  - 2020 Aug 1
TI  - Long-term Results After Surgical or Nonsurgical Treatment in Patients With 
      Degenerative Lumbar Spinal Stenosis: A Prospective Multicenter Study.
PG  - 1030-1038
LID - 10.1097/BRS.0000000000003457 [doi]
AB  - STUDY DESIGN: Prospective, multicenter cohort study. OBJECTIVE: The aim of our 
      study was to assess the course of patients over a period of 3 years undergoing 
      surgical or nonsurgical treatments for degenerative lumbar spinal stenoses (DLSS) 
      based on data from the Lumbar Stenosis Outcome Study (LSOS), prospectively 
      performed in eight hospitals. SUMMARY OF BACKGROUND DATA: The optimal treatment 
      strategy for patients with DLSS is still debated. METHODS: The outcomes of 
      patients with verified DLSS were quantified by Spinal Stenosis Measure (SSM) 
      symptoms- and SSM function-scores, and EQ-5D-3L (quality of life) summary index 
      (SI) over time (up to 36-month follow-up), and minimal clinically important 
      difference (MCID) in SSM symptoms, SSM function, and EQ-5D-3L SI from baseline to 
      36-month follow-up. RESULTS: For this study, 601 patients met the inclusion 
      criteria; 430 underwent surgery, 18 of them only after more than a year after 
      enrolment, 171 received nonsurgical treatment only. At baseline, patients in the 
      surgical and nonsurgical groups had similar values for the SSM symptoms and SSM 
      function scores, but patients in the surgical group suffered significantly more 
      from buttocks pain and reported more worsening symptoms over the last 3 months 
      before enrollment in the study. Surgically treated patients (except changers) 
      performed significantly better in all clinical outcome measures (P < 0.001) with 
      a plateau at 12-month follow-up staying constant until the follow-up ended. 
      Further, two-thirds of patients in the surgical group had a relevant improvement 
      in function, symptoms, and quality of life, compared with only about half of 
      those in terms of symptoms and even less in terms of function and quality of life 
      with nonsurgical treatment. CONCLUSIONS: Surgical treatment of DLSS results in 
      more favorable clinical outcomes with a sustained effect over time, compared to 
      nonsurgical treatment. LEVEL OF EVIDENCE: 3.
FAU - Burgstaller, Jakob M
AU  - Burgstaller JM
AD  - Horten Centre for Patient Oriented Research and Knowledge Transfer, 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 - Gravestock, Isaac
AU  - Gravestock I
AD  - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of 
      Zurich, Zurich, Switzerland.
FAU - Brunner, Florian
AU  - Brunner F
AD  - Department of Physical Medicine and Rheumatology, Balgrist University Hospital, 
      Zurich, Switzerland.
FAU - Fekete, Tamas F
AU  - Fekete TF
AD  - Department of Orthopedics and Neurosurgery, Spine Center, Schulthess Clinic, 
      Zurich, Switzerland.
FAU - Pichierri, Giuseppe
AU  - Pichierri G
AD  - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of 
      Zurich, Zurich, Switzerland.
FAU - Ulrich, Nils H
AU  - Ulrich NH
AD  - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of 
      Zurich, Zurich, Switzerland.
FAU - Winklhofer, Sebastian
AU  - Winklhofer S
AD  - Department of Neuroradiology, University Hospital Zurich, University of Zurich, 
      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  - Department of Orthopedics, University Hospital Balgrist, University of Zurich, 
      Zurich, Switzerland.
CN  - LSOS Study Group
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cohort Studies
MH  - Decompression, Surgical/methods/trends
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Lumbar Vertebrae/*diagnostic imaging/*surgery
MH  - Male
MH  - Middle Aged
MH  - Minimal Clinically Important Difference
MH  - Neurodegenerative Diseases/*diagnostic imaging/*therapy
MH  - Prospective Studies
MH  - Spinal Stenosis/*diagnostic imaging/*therapy
MH  - Treatment Outcome
EDAT- 2020/07/18 06:00
MHDA- 2020/11/04 06:00
CRDT- 2020/07/18 06:00
PHST- 2020/07/18 06:00 [entrez]
PHST- 2020/07/18 06:00 [pubmed]
PHST- 2020/11/04 06:00 [medline]
AID - 00007632-202008010-00008 [pii]
AID - 10.1097/BRS.0000000000003457 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2020 Aug 1;45(15):1030-1038. doi: 
      10.1097/BRS.0000000000003457.