European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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The Roland-Morris Disability Questionnaire (RMDQ) is one of the most recommended questionnaires to assess disability. Some previous studies support the assumption that the RMDQ is a unidimensional measure; however, recent studies have suggested that this measure has more than one domain and should be considered as a multidimensional scale. Therefore, the aim of this study was to analyse the structure of the RMDQ in a large sample of patients with low back pain using two different statistical approaches. ⋯ We recommend that the RMDQ should still be used as a unidimensional scale for measuring disability as the only construct.
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An open decompression is the most common treatment for lumbar spinal canal stenosis (LSS), even in the elderly. However, it is not clear whether the treatment outcome is age dependent. The main purpose of this study was to evaluate the improvement in quality of life (QoL) and pain relief, after open decompression for LSS in relation to patient age. ⋯ Our results confirm that all age groups significantly benefit from the open decompressive treatment of LSS. Age group had no significant influence on any outcome.
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Lumbar spinal stenosis in the presence of degenerative spondylolisthesis is generally treated by means of surgery. The role of lumbar decompression without fusion is not clear. Therefore, the aim of this study was to assess whether patients who undergo decompression alone have a favourable outcome without the need for a subsequent fusion. ⋯ Our study's results show that a lumbar decompression procedure without arthrodesis in a consecutive cohort of patients with lumbar spinal stenosis with degenerative spondylolisthesis had a significant post-operative improvement in ODI, EQ-5D, and VAS. The rate of post-operative instability and subsequent fusion is not high. Only one in 10 patients in this group ended up needing a subsequent fusion at a mean follow-up of 36 months, indicating that fusion is not always necessary in these patients.
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The measurement of distal motor latency (DML) is an established method for diagnosing entrapment peripheral neuropathy. DML can also serve as an index for disease severity and prognosis. We considered that measuring DML could be useful in estimating the severity of spinal root impairment and predicting prognosis in patients with lumbar spinal stenosis (LSS). The purpose of this study was to investigate the efficacy of intraoperative direct electrical stimulation of the spinal root and the measurement of DML in LSS. ⋯ DML is thought to be useful for estimating the severity of spinal root impairment and for predicting the prognosis.
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To evaluate the cost-effectiveness of conservative versus surgical treatment strategies for lumbar spinal stenosis (LSS). ⋯ Both the surgical and the conservative treatment approach resulted in a comparable health-related quality of life within the first year after study inclusion. Due to slightly higher costs, mostly because the majority of initially conservatively treated patients underwent multiple infiltrations or a subsequent surgery, decompressive surgery was identified as the most cost-effective approach for LSS in this setting.