PMID- 37486861
OWN - NLM
STAT- MEDLINE
DCOM- 20231003
LR  - 20231003
IS  - 1547-5646 (Electronic)
IS  - 1547-5646 (Linking)
VI  - 39
IP  - 4
DP  - 2023 Oct 1
TI  - Does low-back pain improve after decompressive spinal surgery? A prospective 
      observational study from the British Spine Registry.
PG  - 583-592
LID - 10.3171/2023.5.SPINE23116 [doi]
AB  - OBJECTIVE: Lumbar spine decompression surgery, in the form of laminectomy or 
      discectomy, is known to be effective in improving symptoms of radiculopathy and 
      neurogenic claudication. However, it is less clear how it impacts coexisting 
      low-back pain (LBP). The aim of this study was to quantify the change in LBP 
      after lumbar decompression. METHODS: This study analyzed data from the British 
      Spine Registry on patients who underwent lumbar decompression surgery. LBP 
      severity was assessed using the visual analog scale (VAS), and the primary 
      outcome was the change in VAS score at 1 year, with secondary outcomes measuring 
      the change in score at 6 weeks, 6 months, and 2 years. The minimal clinically 
      important difference (MCID) was defined as a 30% reduction in pain. RESULTS: Of 
      the 25,349 patients included in the study, 92.2% reported significant back pain 
      at baseline. Of the entire cohort, 12,951 (55.4%) patients had follow-up data for 
      6 weeks, 9066 (38.8%) for 6 months, 7926 (33.9%) for 1 year, and 5517 (23.6%) for 
      2 years; 17,304 (68.3%) patients had follow-up data for at least one time point. 
      Sixty-two percent of patients attained the MCID (VAS score >/= 30%) in back pain 
      reduction, with 51% reporting a substantial improvement (VAS score >/= 50%). This 
      improvement was observed by 6 weeks postoperation and was mostly maintained at 2 
      years. Patients with back pain predominance were more likely to attain the MCID 
      compared with those with leg pain predominance (63.6% vs 60.1%; OR 1.16, 95% CI 
      1.02-1.34; p = 0.0291). Severity of baseline back pain did not reduce the 
      proportion attaining the MCID. CONCLUSIONS: Regardless of pain presentation, LBP 
      improves in approximately 62% of patients who undergo lumbar decompressive 
      surgery, with 51% experiencing substantial improvement. Patients undergoing 
      lumbar decompression can be advised on the chance of a meaningful improvement in 
      back pain postsurgery.
FAU - Knight, James
AU  - Knight J
AD  - Departments of1Neurosurgery and.
FAU - Rangnekar, Ranjit
AU  - Rangnekar R
AD  - Departments of1Neurosurgery and.
FAU - Richardson, Daniel
AU  - Richardson D
AD  - Departments of1Neurosurgery and.
FAU - McIlroy, Suzanne
AU  - McIlroy S
AD  - 2Physiotherapy, King's College Hospital, London.
AD  - 3Psychology Department, Health Psychology Section, King's College London; and.
FAU - Bell, David
AU  - Bell D
AD  - Departments of1Neurosurgery and.
FAU - Ahmed, Aminul I
AU  - Ahmed AI
AD  - Departments of1Neurosurgery and.
AD  - 4Wolfson CARD, Institute of Psychiatry, Psychology and Neuroscience, King's 
      College London, United Kingdom.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20230714
PL  - United States
TA  - J Neurosurg Spine
JT  - Journal of neurosurgery. Spine
JID - 101223545
SB  - IM
MH  - Humans
MH  - Lumbar Vertebrae/surgery
MH  - *Low Back Pain/surgery
MH  - Back Pain/surgery
MH  - *Radiculopathy/surgery
MH  - Registries
MH  - Treatment Outcome
MH  - *Spinal Stenosis/complications/surgery
MH  - Decompression, Surgical
OTO - NOTNLM
OT  - MCID
OT  - discectomy
OT  - laminectomy
OT  - low-back pain
OT  - minimal clinically important difference
OT  - spine
OT  - surgery
EDAT- 2023/07/24 19:09
MHDA- 2023/10/03 06:46
CRDT- 2023/07/24 13:03
PHST- 2023/01/31 00:00 [received]
PHST- 2023/05/15 00:00 [accepted]
PHST- 2023/10/03 06:46 [medline]
PHST- 2023/07/24 19:09 [pubmed]
PHST- 2023/07/24 13:03 [entrez]
AID - 10.3171/2023.5.SPINE23116 [doi]
PST - epublish
SO  - J Neurosurg Spine. 2023 Jul 14;39(4):583-592. doi: 10.3171/2023.5.SPINE23116. 
      Print 2023 Oct 1.