PMID- 37755383
OWN - NLM
STAT- Publisher
LR  - 20230927
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
DP  - 2023 Sep 27
TI  - The Effect of Age-adjusted Sagittal Alignment on the Result of Posterior 
      Decompression Surgery for Lumbar Spinal Canal Stenosis.
LID - 10.1097/BRS.0000000000004836 [doi]
AB  - STUDY DESIGN: Retrospective case series. OBJECTIVE: The aim of this study was to 
      compare the outcomes of posterior decompression surgery for lumbar spinal canal 
      stenosis (LSS) in patients with preoperative sagittal malalignment to those 
      without, after adjusting for age and sex. SUMMARY OF BACKGROUND DATA: Sagittal 
      balance is an important factor in spine surgery and is thought to affect 
      postoperative outcomes following LSS. However, the relationship between sagittal 
      malalignment and postoperative outcomes has not been thoroughly examined. 
      METHODS: We included 533 patients who underwent surgical treatment for LSS and 
      also achieved two-year follow-up. Patients were categorized into either a 
      malalignment (MA+) group (69 patients) or a matched-alignment (MA-) group (348 
      patients) based on age-adjusted preoperative sagittal alignment. We compared the 
      baseline and two-year postoperative health-related quality of life (HRQOL) using 
      the Visual Analog Scale and Japanese Orthopaedic Association Back Pain Evaluation 
      Questionnaire (JOABPEQ) scores. We also calculated clinical efficacy using the 
      minimal clinically important difference (MCID) based on JOABPEQ scores, and age- 
      and sex-adjusted JOABPEQ scores two years after surgery. Differences between 
      groups were examined using the Mann‒Whitney U test and chi 2 analysis, where 
      applicable. RESULTS: Both groups showed an improved HRQOL after decompression 
      surgery. Similar proportions of patients showed substantial improvement, as 
      estimated by the MCID, in four out of five subdomains of the JOABPEQ. A 
      significantly smaller proportion of patients in the MA+ group showed substantial 
      improvement in lumbar function. The age- and sex-adjusted HRQOL scores two years 
      after surgery were lower in the MA+ group, particularly in the lumbar function 
      and social life function subdomains of the JOABPEQ. CONCLUSION: The effects of 
      posterior decompression surgery alone can still be observed at least two years 
      postoperatively for patients with LSS and concomitant sagittal malalignment. 
      Patients with sagittal malalignment may experience lower HRQOL than those without 
      this type of malalignment.
CI  - Copyright (c) 2023 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Kawai, Momotaro
AU  - Kawai M
AD  - Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, 
      Japan.
AD  - Department of Orthopaedic Surgery, Spine Center, Kitasato Institute Hospital, 
      Tokyo, Japan.
AD  - Keio Spine Research Group (KSRG), Tokyo, Japan.
FAU - Yagi, Mitsuru
AU  - Yagi M
AD  - Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, 
      Japan.
AD  - Keio Spine Research Group (KSRG), Tokyo, Japan.
AD  - Department of Orthopaedic Surgery, School of Medicine, International University 
      of Health and Welfare, Chiba, Japan.
FAU - Okubo, Toshiki
AU  - Okubo T
AD  - Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, 
      Japan.
AD  - Keio Spine Research Group (KSRG), Tokyo, Japan.
FAU - Ozaki, Masahiro
AU  - Ozaki M
AD  - Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, 
      Japan.
AD  - Keio Spine Research Group (KSRG), Tokyo, Japan.
FAU - Suzuki, Satoshi
AU  - Suzuki S
AD  - Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, 
      Japan.
AD  - Keio Spine Research Group (KSRG), Tokyo, Japan.
FAU - Takahashi, Yohei
AU  - Takahashi Y
AD  - Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, 
      Japan.
AD  - Keio Spine Research Group (KSRG), Tokyo, Japan.
FAU - Tsuji, Osahiko
AU  - Tsuji O
AD  - Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, 
      Japan.
AD  - Keio Spine Research Group (KSRG), Tokyo, Japan.
FAU - Nagoshi, Narihito
AU  - Nagoshi N
AD  - Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, 
      Japan.
AD  - Keio Spine Research Group (KSRG), Tokyo, Japan.
FAU - Matsumoto, Morio
AU  - Matsumoto M
AD  - Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, 
      Japan.
AD  - Keio Spine Research Group (KSRG), Tokyo, Japan.
FAU - Nakamura, Masaya
AU  - Nakamura M
AD  - Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, 
      Japan.
AD  - Keio Spine Research Group (KSRG), Tokyo, Japan.
FAU - Watanabe, Kota
AU  - Watanabe K
AD  - Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, 
      Japan.
AD  - Keio Spine Research Group (KSRG), Tokyo, Japan.
LA  - eng
PT  - Journal Article
DEP - 20230927
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
COIS- The authors report no conflicts of interest.
EDAT- 2023/09/27 12:42
MHDA- 2023/09/27 12:42
CRDT- 2023/09/27 10:33
PHST- 2023/07/09 00:00 [received]
PHST- 2023/09/13 00:00 [accepted]
PHST- 2023/09/27 12:42 [pubmed]
PHST- 2023/09/27 12:42 [medline]
PHST- 2023/09/27 10:33 [entrez]
AID - 00007632-990000000-00471 [pii]
AID - 10.1097/BRS.0000000000004836 [doi]
PST - aheadofprint
SO  - Spine (Phila Pa 1976). 2023 Sep 27. doi: 10.1097/BRS.0000000000004836.