PMID- 37486867 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 - Improvement in predominant back pain following minimally invasive decompression for spinal stenosis. PG - 576-582 LID - 10.3171/2023.5.SPINE23278 [doi] AB - OBJECTIVE: The objective of this study was to assess the outcomes of patients with predominant back pain (pBP) undergoing minimally invasive decompression surgery compared with patients with nonpredominant back pain (npBP). METHODS: This was a retrospective cohort study. Patients were divided into two groups based on the presenting complaint: 1) pBP, defined as visual analog scale (VAS) back pain score > VAS leg pain score; and 2) npBP. Changes in patient-reported outcome measures (PROMs) were compared at the early (< 6 months) and late (>/= 6 months) postoperative time points. Outcomes measures were: 1) PROMs (Oswestry Disability Index [ODI], VAS back and leg pain scores, 12-Item Short-Form Health Survey Physical Component Score [SF-12 PCS], and Patient-Reported Outcomes Measurement Information System Physical Function [PROMIS PF]), and 2) minimal clinically important difference (MCID) achievement rate and time. For the late MCID achievement point, a second analysis was conducted restricting VAS back and leg pain scores only to patients with preoperative scores >/= 5. RESULTS: Three hundred ninety patients were included (126 with pBP and 264 with npBP). There were no differences in patient demographics and operated levels. There were no differences in preoperative ODI, SF-12 PCS, and PROMIS PF scores. The pBP cohort had a significantly greater preoperative VAS back pain score than the npBP cohort, whereas the npBP cohort had a significantly greater preoperative VAS leg pain score than the pBP cohort. There were no differences in the absolute values or changes in ODI, VAS back pain, SF-12 PCS, and PROMIS PF scores at any time point. There was a significant difference in the early VAS leg pain scores (greater in npBP) that disappeared by the late postoperative time point. There was no difference in the MCID achievement rate in the ODI, SF-12 PCS, or PROMIS PF scores. By the late postoperative time point, 51.2% and 55.3% achieved an MCID on the ODI, 58.1% and 62.7% on the SF-12 PCS, 60% and 67.6% on the PROMIS PF, 81.1% and 73.2% on VAS back pain scores for those with preoperative scores >/= 5, and 72% and 83.6% on VAS leg pain scores for those with preoperative scores >/= 5 for the pBP and npBP cohorts, respectively. Additionally, there were no differences in time to MCID achievement for any PROMs. CONCLUSIONS: The pBP and npBP cohorts showed similar improvement in PROMs and MCID achievement rates. This result shows that minimally invasive laminectomy is equally effective for patients presenting with pBP or npBP. FAU - Korsun, Maximilian K AU - Korsun MK AD - 1Department of Orthopaedics, Hospital for Special Surgery, New York, New York. FAU - Shahi, Pratyush AU - Shahi P AD - 1Department of Orthopaedics, Hospital for Special Surgery, New York, New York. FAU - Shinn, Daniel J AU - Shinn DJ AD - 2Department of Orthopaedics, Weill Cornell Medical College, New York, New York; and. FAU - Pajak, Anthony AU - Pajak A AD - 1Department of Orthopaedics, Hospital for Special Surgery, New York, New York. FAU - Araghi, Kasra AU - Araghi K AD - 1Department of Orthopaedics, Hospital for Special Surgery, New York, New York. FAU - Maayan, Omri AU - Maayan O AD - 1Department of Orthopaedics, Hospital for Special Surgery, New York, New York. AD - 2Department of Orthopaedics, Weill Cornell Medical College, New York, New York; and. FAU - Singh, Nishtha AU - Singh N AD - 1Department of Orthopaedics, Hospital for Special Surgery, New York, New York. FAU - Tuma, Olivia AU - Tuma O AD - 1Department of Orthopaedics, Hospital for Special Surgery, New York, New York. FAU - Asada, Tomoyuki AU - Asada T AD - 1Department of Orthopaedics, Hospital for Special Surgery, New York, New York. AD - 3Department of Orthopaedics, University of Tsukuba, Ibaraki, Japan. FAU - Singh, Sumedha AU - Singh S AD - 1Department of Orthopaedics, Hospital for Special Surgery, New York, New York. FAU - Kim, Ashley Yeo Eun AU - Kim AYE AD - 1Department of Orthopaedics, Hospital for Special Surgery, New York, New York. AD - 2Department of Orthopaedics, Weill Cornell Medical College, New York, New York; and. FAU - Mai, Eric AU - Mai E AD - 1Department of Orthopaedics, Hospital for Special Surgery, New York, New York. AD - 2Department of Orthopaedics, Weill Cornell Medical College, New York, New York; and. FAU - Lu, Amy Z AU - Lu AZ AD - 1Department of Orthopaedics, Hospital for Special Surgery, New York, New York. AD - 2Department of Orthopaedics, Weill Cornell Medical College, New York, New York; and. FAU - Sheha, Evan AU - Sheha E AD - 1Department of Orthopaedics, Hospital for Special Surgery, New York, New York. FAU - Dowdell, James AU - Dowdell J AD - 1Department of Orthopaedics, Hospital for Special Surgery, New York, New York. FAU - Qureshi, Sheeraz AU - Qureshi S AD - 1Department of Orthopaedics, Hospital for Special Surgery, New York, New York. FAU - Iyer, Sravisht AU - Iyer S AD - 1Department of Orthopaedics, Hospital for Special Surgery, New York, New York. LA - eng GR - UL1 TR002384/TR/NCATS NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20230714 PL - United States TA - J Neurosurg Spine JT - Journal of neurosurgery. Spine JID - 101223545 SB - IM MH - Humans MH - *Spinal Stenosis/surgery MH - Retrospective Studies MH - Lumbar Vertebrae/surgery MH - Back Pain/etiology/surgery MH - Minimally Invasive Surgical Procedures/adverse effects MH - Decompression MH - Treatment Outcome MH - *Spinal Fusion OTO - NOTNLM OT - MCID OT - degenerative OT - lumbar decompression OT - minimally invasive OT - outcomes OT - predominant back pain EDAT- 2023/07/24 19:10 MHDA- 2023/10/03 06:47 CRDT- 2023/07/24 13:03 PHST- 2023/03/10 00:00 [received] PHST- 2023/05/19 00:00 [accepted] PHST- 2023/10/03 06:47 [medline] PHST- 2023/07/24 19:10 [pubmed] PHST- 2023/07/24 13:03 [entrez] AID - 10.3171/2023.5.SPINE23278 [doi] PST - epublish SO - J Neurosurg Spine. 2023 Jul 14;39(4):576-582. doi: 10.3171/2023.5.SPINE23278. Print 2023 Oct 1.