PMID- 37343674 OWN - NLM STAT- Publisher LR - 20230715 IS - 1878-8769 (Electronic) IS - 1878-8750 (Linking) DP - 2023 Jun 19 TI - The Implication of Preoperative Central Stenosis on Patient-Reported Outcomes After Lumbar Decompression Surgery. LID - S1878-8750(23)00806-9 [pii] LID - 10.1016/j.wneu.2023.06.038 [doi] AB - OBJECTIVE: To assess the impact of central stenosis severity on patient-reported outcomes after lumbar decompression. METHODS: Patient diagnosis, demographics, and surgical characteristics were collected via query search and manual chart review of electronic medical records. The inclusion criteria were posterior lumbar decompressions from 2014-2020, with accessible magnetic resonance imaging reports. As previously validated by Lee et al., central stenosis was determined on magnetic resonance imaging and graded as none, mild, moderate, or severe. Patients were dichotomized into 2 groups to improve statistical power for comparisons: none or mild central stenosis and moderate or severe central stenosis. Patient-reported outcome measures (PROMs) were compared between cohorts at 1 year postoperatively. Statistical significance was set at P < 0.05. RESULTS: On bivariate analysis, no significant differences were noted between cohorts with regard to preoperative, 1-year postoperative, and delta PROMs. In addition, no significant difference in the number of patients attaining minimal clinically important difference (MCID) for each PROM was noted between cohorts. With the exception of mental score of the Short Form-12 survey, all intragroup preoperative to postoperative PROMs indicated significant improvement (all P < 0.05) after lumbar decompression surgery. Multivariate regression identified moderate or severe central canal stenosis as a significant independent predictor of improvement in visual analog scale back (estimate = -1.464, P = 0.045). CONCLUSIONS: We demonstrate that patients with moderate or severe central spinal stenosis may have more improvement in back pain than those with mild or no central stenosis after lumbar spine decompression surgery. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Yeung, Caleb M AU - Yeung CM AD - Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. FAU - Heard, Jeremy C AU - Heard JC AD - Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. FAU - Lee, Yunsoo AU - Lee Y AD - Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. Electronic address: Yunsoo.Lee@rothmanortho.com. FAU - Lambrechts, Mark J AU - Lambrechts MJ AD - Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri, USA. FAU - Somers, Sydney AU - Somers S AD - Sydney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. FAU - Singh, Akash AU - Singh A AD - Sydney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. FAU - Bloom, Evan AU - Bloom E AD - Sydney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. FAU - D'Antonio, Nicholas D AU - D'Antonio ND AD - Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. FAU - Trenchfield, Delano AU - Trenchfield D AD - Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. FAU - Labarbiera, Anthony AU - Labarbiera A AD - Sydney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. FAU - Mangan, John J AU - Mangan JJ AD - Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. FAU - Canseco, Jose A AU - Canseco JA AD - Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. FAU - Woods, Barrett I AU - Woods BI AD - Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. FAU - Kurd, Mark F AU - Kurd MF AD - Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. FAU - Kaye, Ian D AU - Kaye ID AD - Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. FAU - Lee, Joseph K AU - Lee JK AD - Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. FAU - Hilibrand, Alan S AU - Hilibrand AS AD - Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. FAU - Vaccaro, Alexander R AU - Vaccaro AR AD - Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. FAU - Kepler, Christopher K AU - Kepler CK AD - Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. FAU - Schroeder, Gregory D AU - Schroeder GD AD - Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. LA - eng PT - Journal Article DEP - 20230619 PL - United States TA - World Neurosurg JT - World neurosurgery JID - 101528275 SB - IM OTO - NOTNLM OT - Central stenosis OT - Lumbar decompression OT - Patient-reported outcomes EDAT- 2023/06/22 01:07 MHDA- 2023/06/22 01:07 CRDT- 2023/06/21 19:14 PHST- 2023/04/14 00:00 [received] PHST- 2023/06/10 00:00 [revised] PHST- 2023/06/12 00:00 [accepted] PHST- 2023/06/22 01:07 [pubmed] PHST- 2023/06/22 01:07 [medline] PHST- 2023/06/21 19:14 [entrez] AID - S1878-8750(23)00806-9 [pii] AID - 10.1016/j.wneu.2023.06.038 [doi] PST - aheadofprint SO - World Neurosurg. 2023 Jun 19:S1878-8750(23)00806-9. doi: 10.1016/j.wneu.2023.06.038.