Factors Affecting the Outcome of Lumbar Canal Stenosis Surgery: A Two-year Follow-up Study

Background: Lumbar Canal Stenosis (LCS) is the most common reason for spinal surgery in older patients. Identifying factors influencing the outcome of surgical management is important in clinical research. Objectives: This study aims to identify the factors affecting the outcome of surgical management for LCS. Materials & Methods: This prospective non-randomized cohort study was conducted at the spine center of Imam Khomeini Hospital in Tehran, Iran from March ۲۰۱۷ to January ۲۰۱۹ on ۱۳۵ patients with symptomatic LCS, confirmed by MRI. Clinical and functional outcomes were measured using the ۱۲-Item Short form Health Survey (SF-۱۲), Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) the day before surgery, and ۱۲ and ۲۴ months after surgery. Radiographical parameters was assessed by measuring lumbar lordosis, sacral slope, pelvic tilt and pelvic incidence.  Results: Of ۱۳۵ patients, ۱۲۰ completed the follow-up. Patients treated surgically had significantimprovement in SF-۱۲, ODI and VAS scores after ۲ years of follow-up. Higher values of BMI(P=۰.۰۳۱), symptom duration >۱ year (P=۰.۰۴۵ for SF-۱۲, P=۰.۰۳۱ for ODI), and smoking(P=۰.۰۳۳ for SF-۱۲, P=۰.۰۲۸ for ODI) were associated with poor outcome. Patients with higher pre-operative SF-۱۲, ODI and VAS scores (P=۰.۰۰۷ for SF-۱۲, P=۰.۰۰۳ for ODI, P=۰.۰۵۰ for VAS) and lower lumbar lordosis (P=۰.۰۵۵) showed significant improvement after surgery. Conclusion: Patients with LCS showed significant improvement in outcomes afterdecompression surgery. Higher values of BMI, symptom duration >۱ year, and smokingare associated with poor outcome, while higher pre-operative disability score and lowerlumbar lordosis are associated with better outcome after surgery.

Keywords:

Lumbosacral region , Surgery , Spine , Disease Management