PMID- 34373035
OWN - NLM
STAT- MEDLINE
DCOM- 20211004
LR  - 20211004
IS  - 1532-2653 (Electronic)
IS  - 0967-5868 (Linking)
VI  - 91
DP  - 2021 Sep
TI  - How much change in symptoms do spinal surgeons expect following lumbar 
      decompression and microdiscectomy?
PG  - 243-248
LID - S0967-5868(21)00356-8 [pii]
LID - 10.1016/j.jocn.2021.07.005 [doi]
AB  - The study aimed to determine how much change in neurogenic claudication spinal 
      surgeons expect in patients following lumbar decompression for lumbar spine 
      stenosis (LSS), and radicular leg pain following microdiscectomy. Secondary aims 
      were to identify surgeons' preferences regarding surgical techniques for lumbar 
      decompression, and their rating of the quality of current evidence for lumbar 
      decompression. All Australian spine surgeons were invited, of whom 71 completed 
      the survey (31% response rate). Only registered spinal surgeons were included. 
      The online survey, administered using REDCap, included 4 sections: demographics 
      and background; expected change in symptoms on a +/- 100% scale (-100% worst, 0% 
      no change and 100% best possible); surgical preference; and rating of current 
      evidence for lumbar decompression compared with other treatments. There were 71 
      complete responses, 76% were neurosurgeons (N = 54), predominantly male (96%; 
      N = 68). On average, surgeons expected an 86% (median: 87%, inter-quartile range 
      (IQR): 80%, 91%) improvement in neurogenic claudication following lumbar 
      decompression for LSS and 89% (median: 91%, IQR: 85%, 95%) improvement in 
      radicular pain following microdiscectomy. A multiple linear regression found no 
      surgeon characteristics were associated with expected change following surgery. 
      The preferred surgical technique for LSS was full laminectomy (58%; N = 41). 
      Thirty-five percent of surgeons accurately rated the evidence supporting the 
      superiority of lumbar decompression compared with non-surgical care for LSS as 
      low quality. Spine surgeons expect large symptom improvements following lumbar 
      decompression and microdiscectomy. Understanding of the current evidence was 
      higher for lumbar decompression with fusion, than for decompression alone for 
      LSS.
CI  - Copyright (c) 2021 Elsevier Ltd. All rights reserved.
FAU - Anderson, David B
AU  - Anderson DB
AD  - Faculty of Medicine and Health, The Kolling Institute, Northern Clinical School, 
      The University of Sydney, Sydney, New South Wales, Australia; Graduate School of 
      Health, University of Technology Sydney, New South Wales. Electronic address: 
      david.anderson1@sydney.edu.au.
FAU - Stanford, Ralph
AU  - Stanford R
AD  - Orthopaedic Department, Prince of Wales Hospital, Randwick, New South Wales, 
      Australia.
FAU - Van Gelder, James M
AU  - Van Gelder JM
AD  - Department of Neurosurgery, Liverpool Hospital, University of New South Wales, 
      Sydney, New South Wales, Australia; Sydney Spine Institute, Burwood, New South 
      Wales, Australia.
FAU - Harris, Ian A
AU  - Harris IA
AD  - Ingham Institute for Applied Medical Research, South Western Sydney Clinical 
      School, UNSW Sydney, New South Wales, Australia; Institute for Musculoskeletal 
      Health, The University of Sydney and Sydney Local Health District, Sydney, New 
      South Wales, Australia.
FAU - Eyles, Jillian
AU  - Eyles J
AD  - Faculty of Medicine and Health, The Kolling Institute, Northern Clinical School, 
      The University of Sydney, Sydney, New South Wales, Australia.
FAU - Damodaran, Omprakash
AU  - Damodaran O
AD  - Department of Neurosurgery, Concord General Repatriation Hospital, Concord, New 
      South Wales, Australia.
FAU - Maher, Christopher G
AU  - Maher CG
AD  - Institute for Musculoskeletal Health, The University of Sydney and Sydney Local 
      Health District, Sydney, New South Wales, Australia.
FAU - Ferreira, Manuela L
AU  - Ferreira ML
AD  - Faculty of Medicine and Health, The Kolling Institute, Northern Clinical School, 
      The University of Sydney, Sydney, New South Wales, Australia.
LA  - eng
PT  - Journal Article
DEP - 20210722
PL  - Scotland
TA  - J Clin Neurosci
JT  - Journal of clinical neuroscience : official journal of the Neurosurgical Society 
      of Australasia
JID - 9433352
SB  - IM
MH  - Australia
MH  - Back Pain
MH  - *Decompression, Surgical
MH  - Female
MH  - Humans
MH  - Lumbar Vertebrae/surgery
MH  - Male
MH  - Neurosurgeons
MH  - Neurosurgical Procedures
MH  - *Spinal Stenosis/surgery
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Low Back Pain
OT  - Lumbar Vertebrae
OT  - Spinal Stenosis
OT  - Spine
OT  - Surgery
OT  - Surgical Decompression
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2021/08/11 06:00
MHDA- 2021/10/05 06:00
CRDT- 2021/08/10 05:43
PHST- 2021/03/15 00:00 [received]
PHST- 2021/07/04 00:00 [accepted]
PHST- 2021/08/10 05:43 [entrez]
PHST- 2021/08/11 06:00 [pubmed]
PHST- 2021/10/05 06:00 [medline]
AID - S0967-5868(21)00356-8 [pii]
AID - 10.1016/j.jocn.2021.07.005 [doi]
PST - ppublish
SO  - J Clin Neurosci. 2021 Sep;91:243-248. doi: 10.1016/j.jocn.2021.07.005. Epub 2021 
      Jul 22.