gms | German Medical Science

66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

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Clinical outcome in lumbar decompression surgery for spinal canal stenosis in the aged population: a prospective Swiss multicenter cohort study

Meeting Abstract

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  • Nils H. Ulrich - Department of Orthopedics, University Hospital Balgrist, University of Zurich, Switzerland
  • Frank Kleinstück - Department of Orthopedics and Neurosurgery, Spine Center, Schulthess Clinic, Zurich, Switzerland
  • Christoph M. Woernle - Department of Orthopedics, University Hospital Balgrist, University of Zurich, Switzerland
  • Alexander Antoniadis - Department of Orthopedics, University Hospital Balgrist, University of Zurich, Switzerland
  • Sebastian Winklhofer - Department of Radiology, University Hospital Balgrist, University of Zurich, Switzerland
  • Jakob M. Burgstaller - Horten Centre for Patient Oriented Research and Knowledge Transfer
  • Mazda Farshad - Department of Orthopedics, University Hospital Balgrist, University of Zurich, Switzerland
  • Joachim Oberle - Department of Neurosurgery, Kantonsspital Winterthur, Switzerland
  • Francois Porchet - Department of Orthopedics and Neurosurgery, Spine Center, Schulthess Clinic, Zurich, Switzerland
  • Kan Min - Department of Orthopedics, University Hospital Balgrist, University of Zurich, Switzerland

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocMI.01.05

doi: 10.3205/15dgnc253, urn:nbn:de:0183-15dgnc2535

Published: June 2, 2015

© 2015 Ulrich et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: This is a prospective, multicenter cohort study including eight medical centers in the metropolitan area of the Canton Zurich, Switzerland. To examine whether outcome and quality of life might improve after decompression for degenerative lumbar spinal stenosis (DLSS) even in patients over 80 years of age and to compare data with a younger patient population from our own patient collective. Lumbar decompression surgery without fusion has been shown to improve quality of life in lumbar spinal canal stenosis. In the elderly population over 80 years of age treatment recommendations for DLSS show conflicting results.

Method: Eight centers in the metropolitan area of Zurich, Switzerland agreed on the classification of DLSS, surgical principles and follow-up protocols. Patients were followed from baseline, at 6 months and 12 months. Baseline characteristics were analyzed with 5 different questionnaires (Spinal Stenosis Measure, Feeling Thermometer, Numeric Rating Scale, 5D-3L, Roland and Morris Disability Questionnaire). In addition our study population was compared to a younger control group. Further we calculated the minimal clinical important differences (MCID).

Results: Thirty-seven patients with an average age of 82.5 ± 2.5 years reached the 12 months follow-up. Spinal Stenosis Measure-scores (SSM), the Feeling Thermometer, the Numeric Rating Scale (NRS) and the Roland & Morris Disability showed significant improvements at the 6 months and 12 months follow-up (p<0.001). One EQ-5D-3L subgroup (anxiety/depression) showed no significant improvement (p=0.109) at 12 months follow-up. The MCID for the symptom severity scale in the SSM was achieved with improvement of 70% in the older patient population.

Conclusions: Patients of 80 years of age and older can expect a clinically meaningful improvement after lumbar decompression for symptomatic DLSS. Our patient population showed significant positive development in quality of life in the short- and long-term follow-up.