• F Beyer, F Geier, J Bredow, J Oppermann, P Eysel, and R Sobottke.
• Department of Orthopedic and Trauma Surgery, Marien Krankenhaus gGmbH, Bergisch Gladbach, Germany.
• Technol Health Care. 2015 Jan 1; 23 (6): 871-9.

BackgroundNon-operative treatment is widely accepted for early stages of lumbar spinal stenosis. In general, a trial of conservative treatment is recommended prior to surgery.ObjectiveThe influence of sagittal alignment on treatment outcomes remains unclear.MethodsTwenty-five patients were included in this prospective study. All patients received repeated epidural injections and facet joint injections as well as physiotherapy during a one week hospitalization. Patient characteristics, VAS scores, COMI scores, ODI scores and SF-36 were assessed prior to and immediately after treatment as well as after six, twelve, and 26 weeks. Spinopelvic parameter measurements were performed. Outcome parameters were correlated to spinopelvic parameters.ResultsODI and PCSS scores improved significantly up to three months follow-up. COMI score improved significantly over the entire follow-up. Back pain improvement at six weeks and three months follow-up correlated inversely with pelvic incidence. Sacral slope correlated significantly with ODI improvement immediately after therapy. Low lumbar lordosis also correlated significantly with ODI improvement at three months follow-up.ConclusionsSubjects with higher pelvic incidence reported significantly greater back pain improvements at three months follow-up. ODI improvements were higher for patients with high sacral slope immediately after treatment and for patients with a higher lumbar lordosis after three months. No influence of sagittal alignment was observed on leg pain or quality of life.

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