Time Course of Asymptomatic Stenosis in Multiple Lumbar Spinal Stenosis—Five-Year Results of Selective Decompression of Symptomatic Levels
Abstract
:1. Introduction
2. Materials and Methods
2.1. Definition of L3–4 Stenosis
2.2. Diagnosis of Symptomatic and Asymptomatic Levels
2.3. Statistical Analysis
3. Results
3.1. Recruitment of Patients
3.2. Characteristics of Patients in the Single and Double Groups
3.3. Outcomes of 5-Year Follow-up
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Motor | Sensory | Reflex | |
---|---|---|---|
L4 | Quadriceps | Medial knee | PTR |
L5 | TA EHL EDL | Lateral lower extremity and dorsal foot | |
S1 | Gastrocnemius FHL FDL | Lateral foot | ATR |
Double Group Mean [SD], n (%) | Single Group | p-Value | |
---|---|---|---|
Cases | 16 | 121 | |
Age (y) | 68.6 [9.3] | 66.7 [10.3] | 0.45 |
Sex Male Female | 10 (62.5) 6 (37.5) | 73 (60.3) 48 (39.7) | 0.87 |
BMI | 25.9 [2.1] | 24.9 [3.3] | 0.23 |
Smoking No Past Present | 11 (68.9) 4 (25) 1(6.3) | 78 (64.5) 23 (19) 20 (1.5) | 0.53 |
DM | 4 (25) | 18 (14.9) | 0.26 |
L3–4 DSCA (mm2) | 43.9 [4.5] | 100.6 [38.7] | <0.01 |
L4 spondylolisthesis | 5(31.3) | 56(46.3) | 0.26 |
MEL | 4 (25) | 31(25.6) | 0.67 |
NRS scores | |||
Low back pain | 5.8 [3.3] | 3.8 [3.3] | 0.06 |
Leg pain | 5.2 [3.3] | 5.5 [3.6] | 0.72 |
Leg numbness | 6.1 [3.7] | 5.8 [3.1] | 0.67 |
RDQ total score | 10.6 [6.0] | 11.2 [5.7] | 0.72 |
RDQ deviation score | 38.3 [8.7] | 39.1 [10.1] | 0.86 |
Double Group n (%) | Single Group | p-Value | |
---|---|---|---|
Cases | 12 | 86 | |
L4 symptoms | 2 (16.7) | 9 (10.5) | 0.54 |
L3–4 surgery | 1 (8.3) | 3 (3.5) | 0.47 |
Residual symptoms | 6 (50) | 38 (44.2) | 0.7 |
L4–5 revision surgery | 1 (8.3) | 4 (4.7) | 0.61 |
Double Group (n = 10) Mean [SD] | Single Group (n = 63) | p-Value # | |||||||
---|---|---|---|---|---|---|---|---|---|
Pre-Op | 5-year Post-Op | Post-op Change | p-Value * | Pre-op | 5-year Post-Op | Post-op Change | p-Value * | ||
NRS scores | |||||||||
Low back pain | 5.1 [3.4] | 4.1 [2.9] | −0.9 [3.2] | 0.41 | 3.4 [3.3] | 2.5 [3.2] | −1.0 [3.5] | 0.03 | 0.97 |
Leg pain | 5.2 [3.4] | 2.5 [2.8] | −2.7 [3.6] | 0.04 | 5.2 [3.4] | 2.5 [2.9] | −2.7 [3.7] | <0.01 | 0.99 |
Leg numbness | 5.7 [4.0] | 3.2 [2.4] | −2.4 [4.9] | 0.18 | 5.3 [3.2] | 3.2 [3.3] | −2.2 [3.9] | <0.01 | 0.84 |
RDQ scores | |||||||||
Total score | 11.9 [5.7] | 8.6 [6.3] | −3.3 [5.3] | 0.15 | 11.4 [5.5] | 5.7 [5.8] | −5.7 [7.4] | <0.01 | 0.4 |
Norm-based score | 36.5 [9.6] | 43.0 [11.3] | 6.5 [10.1] | 0.14 | 39.8 [9.7] | 49.4 [10.9] | 9.6 [13.8] | <0.01 | 0.57 |
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Watanabe, K.; Otani, K.; Nikaido, T.; Kato, K.; Kobayashi, H.; Yabuki, S.; Konno, S.-i.; Matsumoto, Y. Time Course of Asymptomatic Stenosis in Multiple Lumbar Spinal Stenosis—Five-Year Results of Selective Decompression of Symptomatic Levels. Medicina 2024, 60, 636. https://doi.org/10.3390/medicina60040636
Watanabe K, Otani K, Nikaido T, Kato K, Kobayashi H, Yabuki S, Konno S-i, Matsumoto Y. Time Course of Asymptomatic Stenosis in Multiple Lumbar Spinal Stenosis—Five-Year Results of Selective Decompression of Symptomatic Levels. Medicina. 2024; 60(4):636. https://doi.org/10.3390/medicina60040636
Chicago/Turabian StyleWatanabe, Kazuyuki, Koji Otani, Takuya Nikaido, Kinshi Kato, Hiroshi Kobayashi, Shoji Yabuki, Shin-ichi Konno, and Yoshihiro Matsumoto. 2024. "Time Course of Asymptomatic Stenosis in Multiple Lumbar Spinal Stenosis—Five-Year Results of Selective Decompression of Symptomatic Levels" Medicina 60, no. 4: 636. https://doi.org/10.3390/medicina60040636