- Email: [email protected]
Long-Term Outcomes Following Lumbar Microendoscopic Decompression for Lumbar Spinal Stenosis with and without Degenerative Spondylolisthesis: Minimum 10-Year Follow-Up
Journal Pre-proof Long-term outcomes following lumbar microendoscopic decompression for lumbar spinal stenosis with and without degenerative spondylolisthesis: Minimum 10-year follow-up Takato Aihara, M.D., Ph.D, Kenji Endo, M.D., Ph.D, Hidekazu Suzuki, M.D., Ph.D, Atsushi Kojima, M.D., Ph.D, Yasunobu Sawaji, Ph.D, Makoto Urushibara, M.D., Ph.D, Yuji Matsuoka, M.D., Ph.D, Taichiro Takamatsu, M.D., Ph.D, Kazuma Murata, M.D., Ph.D, Takamitsu Konishi, M.D, Hideya Yamauchi, M.D, Hiroo Endo, M.D, Kengo Yamamoto, M.D., Ph.D PII:
S1878-8750(20)32516-X
DOI:
https://doi.org/10.1016/j.wneu.2020.11.131
Reference:
WNEU 16402
To appear in:
World Neurosurgery
Received Date: 11 August 2020 Revised Date:
21 November 2020
Accepted Date: 23 November 2020
Please cite this article as: Aihara T, Endo K, Suzuki H, Kojima A, Sawaji Y, Urushibara M, Matsuoka Y, Takamatsu T, Murata K, Konishi T, Yamauchi H, Endo H, Yamamoto K, Long-term outcomes following lumbar microendoscopic decompression for lumbar spinal stenosis with and without degenerative spondylolisthesis: Minimum 10-year follow-up, World Neurosurgery (2020), doi: https://doi.org/10.1016/ j.wneu.2020.11.131. This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. © 2020 Elsevier Inc. All rights reserved.
Long-term outcomes following lumbar microendoscopic decompression for lumbar spinal stenosis with and without degenerative spondylolisthesis: Minimum 10-year follow-up Takato Aihara1, 2, M.D., Ph.D., Kenji Endo2, M.D., Ph.D., Hidekazu Suzuki2, M.D., Ph.D., Atsushi Kojima1, M.D., Ph.D., Yasunobu Sawaji2, Ph.D., Makoto Urushibara1, M.D., Ph.D., Yuji Matsuoka2, M.D., Ph.D., Taichiro Takamatsu2, M.D., Ph.D., Kazuma Murata2, M.D., Ph.D., Takamitsu Konishi2, M.D., Hideya Yamauchi2, M.D., Hiroo Endo2, M.D., and Kengo Yamamoto2, M.D., Ph.D. Department of Orthopedic Surgery, Funabashi Orthopedic Hospital
2
Department of Orthopedic Surgery, Tokyo Medical University
ro
of
1
Name and address for correspondence:
-p
Takato Aihara, M.D., Ph.D.
re
Funabashi Orthopedic Hospital
1-833 Hasama, Funabashi-city, Chiba 274-0822, Japan
na
E-mail: [email protected]
Fax: 81 / 47-425-6592
lP
TEL: 81 / 47-425-5585
Key words: Degenerative lumbar spondylolisthesis; Long-term outcomes;
ur
Lumbar spinal stenosis; Microendoscopic decompression; Minimum 10-year follow-up;
Jo
Patient-based outcome measure; Preoperative radiological predictor Short title: LUMBAR MICROENDOSCOPIC DECOMPRESSION Declarations of interest: none This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Table 1. Patient data (n=80)
DS group (n=34)
SS group (n=46)
Mean age at surgery (years)
63.2
59.8
(standard deviation; range)
(8.76; 43 to 77)
(9.49; 40 to 74)
Female, n (%)
14 (41.2)
9 (19.6)
P value
0.104
of 5
-p
L3/4
ro
Levels of surgery (n)
29
2
5
3
5
1
1
140.8
136.7
lP
na
L3/4 and L4/5
ur
L4/5 and L5/S1
Jo
Mean follow-up (months)
(standard deviation; range) Follow-up rate (%)
6
23
re
L4/5 L5/S1
0.0348*
0.155 (11.5; 120 to 159) (11.6; 120 to 159) 34/41 (82.9)
46/59 (78.0)
* The gender difference between the two groups was significant.
P value
Preoperative
42.4±32.3
39.1±30.3
0.693
Postoperative
76.1±28.1
75.8±35.1
0.563
Preoperative
51.7±32.3
Postoperative
77.9±24.4
80.8±25.8
0.477
Preoperative
23.3±19.8
30.3±21.6
0.172
66.0±33.0
67.7±33.7
0.775
28.7±20.9
35.3±21.7
0.166
Postoperative
62.8±26.5
66.5±25.4
0.573
Preoperative
42.5±17.5
42.7±16.0
0.793
Postoperative
58.3±19.8
56.6±20.1
0.830
-p
lP
na
Gait disturbance
ur
Postoperative
Preoperative
Jo
Social life disturbance
Psychological disorders
50.2±28.5
0.777
ro
Lumbar spine dysfunction
SS group (n=46)
of
Pain-related disorders
DS group (n=34)
re
Table 2. Preoperative and postoperative JOABPEQ scores in DS and SS groups
Values are expressed as mean ± standard deviation.
Table 3. Preoperative and postoperative VAS scores in DS and SS groups
Preoperative
51.3±30.6
46.8±27.1
0.501
Postoperative
32.9±31.7
29.9±27.9
0.661
Preoperative
70.7±23.8
67.3±23.6
Postoperative
30.4±34.1
Preoperative
29.4±28.2
0.884
70.3±24.2
59.5±27.6
0.0780
30.5±31.6
28.6±30.1
0.781
ro
0.532
na
lP
Postoperative
of
Leg numbness
P value
-p
Leg pain
SS group (n=46)
re
Low back pain
DS group (n=34)
Jo
ur
Values are expressed as mean ± standard deviation.
Table 4. Degrees of improvement and intensities of improvement in DS and SS groups
SS group (n=46)
P value
Pain-related disorders
36.9±34.4
38.3±40.4
0.872
Lumbar spine dysfunction
27.9±37.8
31.8±35.9
0.644
Gait disturbance
42.6±38.9
Social life disturbance Psychological disorders
0.567
34.1±34.1
31.2±34.7
0.710
15.8±26.9
13.9±21.8
0.731
20.8±36.3
18.1±32.7
0.729
Leg pain
42.0±40.6
38.9±37.2
0.726
39.6±40.6
32.0±41.3
0.422
re
lP
na
ur
Low back pain
-p
37.4±41.1
Jo
ro
of
DS group (n=34)
Leg numbness
Values are expressed as mean ± standard deviation. Degree of improvement was calculated by the following formula: postoperative score − preoperative score of JOABPEQ Intensity of improvement was calculated by the following formula: preoperative score − postoperative score of VAS
Table 5. Preoperative radiographic measurements in E and I groups concerning JOABPEQ Pain-related
Lumbar spine
Gait
Social life
Psychological
disorders
dysfunction
disturbance
disturbance
disorders
E group
12.3±5.66%
13.1±6.23%
13.1±5.23%
12.0±4.50%
12.5±5.15%
I group
12.6±6.88%
12.4±6.67%
13.1±8.44%
14.8±8.31%
13.4±6.87%
E group
15.3±7.32%
16.3±7.65%
15.9±6.82%
I group
15.3±8.37%
15.0±7.58%
E group
5.59±3.92%
I group
5.12±4.15%
Percentage of slipping in neutral position
slipping
15.4±5.60%
16.8±6.19%
16.1±9.53%
16.9±10.2%
15.6±8.33%
5.88±3.77%
5.95±3.28%
6.93±2.95%
3.87±5.14%
4.18±3.75%
4.35±4.40%
4.62±3.95%
-1.89±4.24°
-1.38±5.51°
-2.86±4.66°
-4.06±4.99°
ur
E group
-1.08±5.45°
Jo
at flexion
Intervertebral range of motion
Disc height ratio
-p
re
na
flexion-extension
Intervertebral angle
6.19±2.81%
lP
translation during
ro
at flexion
Percentage
of
Percentage of
I group
-2.79±4.42°
-2.60±7.30°
-3.70±4.85°
-1.08±6.27°
-1.33±5.38°
E group
11.0±5.22°
11.4±4.74°
12.2±4.87°
12.5±4.74°
13.4±5.59°
I group
11.1±5.08°
10.8±6.03°
9.65±5.20°
9.63±5.18°
10.5±4.65°
E group
0.270±0.055
0.257±0.052
0.275±0.052
0.269±0.046
0.276±0.043
I group
0.252±0.064
0.267±0.052
0.241±0.056
0.256±0.068
0.258±0.059
Values are expressed as mean ± standard deviation.
at flexion
Percentage translation
13.7±6.63%
12.8±5.73%
I group
13.5±6.47%
12.8±5.75%
14.3±7.10%
E group
16.2±8.75%
16.1±7.75%
15.2±7.45%
I group
16.6±7.02%
E group
4.70±4.43%
4.43±3.61%
5.41±4.05%
I group
5.80±3.49%
6.95±3.93%
5.14±3.72%
E group
-1.62±6.23°
-1.74±5.84°
-2.00±6.01°
-2.37±4.53°
-2.20±4.11°
-1.75±4.15°
E group
10.5±4.45°
10.7±3.91°
10.9±4.89°
I group
12.2±5.58°
12.3±6.93°
11.7±5.55°
E group
0.257±0.060
0.258±0.052
0.263±0.057
I group
0.278±0.049
0.280±0.061
0.269±0.055
na
Intervertebral angle
13.6±6.39%
lP
during flexion-extension
E group
ur
at flexion
Jo
I group
Intervertebral range of motion
Disc height ratio
of
Percentage of slipping
Leg numbness
16.2±8.12%
ro
in neutral position
Leg pain
-p
Percentage of slipping
Low back pain
re
Table 6. Preoperative radiographic measurements in E and I groups concerning VAS
Values are expressed as mean ± standard deviation.
17.5±8.25%
DS group 80
SS group
%
f
70
epr
oo
60
Pr
50
rn
al
40
Jo u
30 20 10 0
Pain-related disorders
Lumbar spine dysfunction
Gait disturbance
Social life disturbance
Psychological disorders
Figure 1. Effectiveness rates in the DS and SS groups
Preoperative
Postoperative
＊P<0.05 80
＊
＊
70
＊ oo
f
60
epr
50
al rn Jo u
30 20
Pr
40
10 0
Low back pain
Leg pain
Leg numbness
Figure 2. Mean preoperative and postoperative VAS scores in the DS group
Preoperative
Postoperative
＊P<0.05 70
＊ ＊
60
oo
f
＊ epr
50
Pr
40
rn Jo u
20
al
30
10 0
Low back pain
Leg pain
Leg numbness
Figure 3. Mean preoperative and postoperative VAS scores in the SS group
Abbreviations
DOI: Degree of improvement DS: Degenerative lumbar spondylolisthesis E (group): Effective (group) I (group): Ineffective (group) IOI: Intensity of improvement
of
JOABPEQ: Japanese Orthopaedic Association Back Pain Evaluation Questionnaire
MED: Microendoscopic decompression
re
SS: Lumbar spinal stenosis
-p
MCID: Minimal clinically important difference
ur
na
lP
VAS: Visual analogue scale
Jo
ro
LBP: Low back pain
OBJECTIVE: To determine whether preoperative presence of degenerative lumbar spondylolisthesis (DS) worsens the minimum 10-year outcome of patients undergoing microendoscopic decompression (MED) for lumbar spinal stenosis (SS). METHODS: Eighty patients undergoing MED were classified into two groups: DS group (34 SS with DS patients) and SS group (46 SS without DS patients). The degrees of improvement (DOIs) by the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and intensities of improvement (IOIs) by visual analogue scale (VAS) at 120~159 (mean, 138.4) months after MED of the DS and SS groups were statistically compared. Patients with DS were classified into two groups based on the effectiveness by VAS or JOABPEQ: effective group (E group: IOI or DOI ≥20) and ineffective group (I group).
of
All preoperative radiological measurements were statistically compared between the E and I
ro
groups.
RESULTS: Significant decreases in low back pain (LBP), leg pain and numbness, as
-p
measured by VAS, were noted at follow-up in the DS and SS groups. The effectiveness rates
re
of pain-related disorders, lumbar spine dysfunction, and gait disturbance by JOABPEQ were almost equally high in the DS and SS groups. Statistical comparisons of the DOIs in all five
lP
functional scores and IOIs in LBP, leg pain and numbness showed no significant differences between the DS and SS groups. No significant differences were confirmed between the E and
na
I groups concerning preoperative spondylolisthesis and instability. CONCLUSIONS: Our study indicated that preoperative DS did not worsen the outcome of
Jo
ur
patients with SS undergoing MED.
Declaration of interests ☒ The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
☐ The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:
Jo
ur
na
lP
re
-p
ro
of
Declarations of interest: none
S1878-8750(20)32516-X
DOI:
https://doi.org/10.1016/j.wneu.2020.11.131
Reference:
WNEU 16402
To appear in:
World Neurosurgery
Received Date: 11 August 2020 Revised Date:
21 November 2020
Accepted Date: 23 November 2020
Please cite this article as: Aihara T, Endo K, Suzuki H, Kojima A, Sawaji Y, Urushibara M, Matsuoka Y, Takamatsu T, Murata K, Konishi T, Yamauchi H, Endo H, Yamamoto K, Long-term outcomes following lumbar microendoscopic decompression for lumbar spinal stenosis with and without degenerative spondylolisthesis: Minimum 10-year follow-up, World Neurosurgery (2020), doi: https://doi.org/10.1016/ j.wneu.2020.11.131. This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. © 2020 Elsevier Inc. All rights reserved.
Long-term outcomes following lumbar microendoscopic decompression for lumbar spinal stenosis with and without degenerative spondylolisthesis: Minimum 10-year follow-up Takato Aihara1, 2, M.D., Ph.D., Kenji Endo2, M.D., Ph.D., Hidekazu Suzuki2, M.D., Ph.D., Atsushi Kojima1, M.D., Ph.D., Yasunobu Sawaji2, Ph.D., Makoto Urushibara1, M.D., Ph.D., Yuji Matsuoka2, M.D., Ph.D., Taichiro Takamatsu2, M.D., Ph.D., Kazuma Murata2, M.D., Ph.D., Takamitsu Konishi2, M.D., Hideya Yamauchi2, M.D., Hiroo Endo2, M.D., and Kengo Yamamoto2, M.D., Ph.D. Department of Orthopedic Surgery, Funabashi Orthopedic Hospital
2
Department of Orthopedic Surgery, Tokyo Medical University
ro
of
1
Name and address for correspondence:
-p
Takato Aihara, M.D., Ph.D.
re
Funabashi Orthopedic Hospital
1-833 Hasama, Funabashi-city, Chiba 274-0822, Japan
na
E-mail: [email protected]
Fax: 81 / 47-425-6592
lP
TEL: 81 / 47-425-5585
Key words: Degenerative lumbar spondylolisthesis; Long-term outcomes;
ur
Lumbar spinal stenosis; Microendoscopic decompression; Minimum 10-year follow-up;
Jo
Patient-based outcome measure; Preoperative radiological predictor Short title: LUMBAR MICROENDOSCOPIC DECOMPRESSION Declarations of interest: none This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Table 1. Patient data (n=80)
DS group (n=34)
SS group (n=46)
Mean age at surgery (years)
63.2
59.8
(standard deviation; range)
(8.76; 43 to 77)
(9.49; 40 to 74)
Female, n (%)
14 (41.2)
9 (19.6)
P value
0.104
of 5
-p
L3/4
ro
Levels of surgery (n)
29
2
5
3
5
1
1
140.8
136.7
lP
na
L3/4 and L4/5
ur
L4/5 and L5/S1
Jo
Mean follow-up (months)
(standard deviation; range) Follow-up rate (%)
6
23
re
L4/5 L5/S1
0.0348*
0.155 (11.5; 120 to 159) (11.6; 120 to 159) 34/41 (82.9)
46/59 (78.0)
* The gender difference between the two groups was significant.
P value
Preoperative
42.4±32.3
39.1±30.3
0.693
Postoperative
76.1±28.1
75.8±35.1
0.563
Preoperative
51.7±32.3
Postoperative
77.9±24.4
80.8±25.8
0.477
Preoperative
23.3±19.8
30.3±21.6
0.172
66.0±33.0
67.7±33.7
0.775
28.7±20.9
35.3±21.7
0.166
Postoperative
62.8±26.5
66.5±25.4
0.573
Preoperative
42.5±17.5
42.7±16.0
0.793
Postoperative
58.3±19.8
56.6±20.1
0.830
-p
lP
na
Gait disturbance
ur
Postoperative
Preoperative
Jo
Social life disturbance
Psychological disorders
50.2±28.5
0.777
ro
Lumbar spine dysfunction
SS group (n=46)
of
Pain-related disorders
DS group (n=34)
re
Table 2. Preoperative and postoperative JOABPEQ scores in DS and SS groups
Values are expressed as mean ± standard deviation.
Table 3. Preoperative and postoperative VAS scores in DS and SS groups
Preoperative
51.3±30.6
46.8±27.1
0.501
Postoperative
32.9±31.7
29.9±27.9
0.661
Preoperative
70.7±23.8
67.3±23.6
Postoperative
30.4±34.1
Preoperative
29.4±28.2
0.884
70.3±24.2
59.5±27.6
0.0780
30.5±31.6
28.6±30.1
0.781
ro
0.532
na
lP
Postoperative
of
Leg numbness
P value
-p
Leg pain
SS group (n=46)
re
Low back pain
DS group (n=34)
Jo
ur
Values are expressed as mean ± standard deviation.
Table 4. Degrees of improvement and intensities of improvement in DS and SS groups
SS group (n=46)
P value
Pain-related disorders
36.9±34.4
38.3±40.4
0.872
Lumbar spine dysfunction
27.9±37.8
31.8±35.9
0.644
Gait disturbance
42.6±38.9
Social life disturbance Psychological disorders
0.567
34.1±34.1
31.2±34.7
0.710
15.8±26.9
13.9±21.8
0.731
20.8±36.3
18.1±32.7
0.729
Leg pain
42.0±40.6
38.9±37.2
0.726
39.6±40.6
32.0±41.3
0.422
re
lP
na
ur
Low back pain
-p
37.4±41.1
Jo
ro
of
DS group (n=34)
Leg numbness
Values are expressed as mean ± standard deviation. Degree of improvement was calculated by the following formula: postoperative score − preoperative score of JOABPEQ Intensity of improvement was calculated by the following formula: preoperative score − postoperative score of VAS
Table 5. Preoperative radiographic measurements in E and I groups concerning JOABPEQ Pain-related
Lumbar spine
Gait
Social life
Psychological
disorders
dysfunction
disturbance
disturbance
disorders
E group
12.3±5.66%
13.1±6.23%
13.1±5.23%
12.0±4.50%
12.5±5.15%
I group
12.6±6.88%
12.4±6.67%
13.1±8.44%
14.8±8.31%
13.4±6.87%
E group
15.3±7.32%
16.3±7.65%
15.9±6.82%
I group
15.3±8.37%
15.0±7.58%
E group
5.59±3.92%
I group
5.12±4.15%
Percentage of slipping in neutral position
slipping
15.4±5.60%
16.8±6.19%
16.1±9.53%
16.9±10.2%
15.6±8.33%
5.88±3.77%
5.95±3.28%
6.93±2.95%
3.87±5.14%
4.18±3.75%
4.35±4.40%
4.62±3.95%
-1.89±4.24°
-1.38±5.51°
-2.86±4.66°
-4.06±4.99°
ur
E group
-1.08±5.45°
Jo
at flexion
Intervertebral range of motion
Disc height ratio
-p
re
na
flexion-extension
Intervertebral angle
6.19±2.81%
lP
translation during
ro
at flexion
Percentage
of
Percentage of
I group
-2.79±4.42°
-2.60±7.30°
-3.70±4.85°
-1.08±6.27°
-1.33±5.38°
E group
11.0±5.22°
11.4±4.74°
12.2±4.87°
12.5±4.74°
13.4±5.59°
I group
11.1±5.08°
10.8±6.03°
9.65±5.20°
9.63±5.18°
10.5±4.65°
E group
0.270±0.055
0.257±0.052
0.275±0.052
0.269±0.046
0.276±0.043
I group
0.252±0.064
0.267±0.052
0.241±0.056
0.256±0.068
0.258±0.059
Values are expressed as mean ± standard deviation.
at flexion
Percentage translation
13.7±6.63%
12.8±5.73%
I group
13.5±6.47%
12.8±5.75%
14.3±7.10%
E group
16.2±8.75%
16.1±7.75%
15.2±7.45%
I group
16.6±7.02%
E group
4.70±4.43%
4.43±3.61%
5.41±4.05%
I group
5.80±3.49%
6.95±3.93%
5.14±3.72%
E group
-1.62±6.23°
-1.74±5.84°
-2.00±6.01°
-2.37±4.53°
-2.20±4.11°
-1.75±4.15°
E group
10.5±4.45°
10.7±3.91°
10.9±4.89°
I group
12.2±5.58°
12.3±6.93°
11.7±5.55°
E group
0.257±0.060
0.258±0.052
0.263±0.057
I group
0.278±0.049
0.280±0.061
0.269±0.055
na
Intervertebral angle
13.6±6.39%
lP
during flexion-extension
E group
ur
at flexion
Jo
I group
Intervertebral range of motion
Disc height ratio
of
Percentage of slipping
Leg numbness
16.2±8.12%
ro
in neutral position
Leg pain
-p
Percentage of slipping
Low back pain
re
Table 6. Preoperative radiographic measurements in E and I groups concerning VAS
Values are expressed as mean ± standard deviation.
17.5±8.25%
DS group 80
SS group
%
f
70
epr
oo
60
Pr
50
rn
al
40
Jo u
30 20 10 0
Pain-related disorders
Lumbar spine dysfunction
Gait disturbance
Social life disturbance
Psychological disorders
Figure 1. Effectiveness rates in the DS and SS groups
Preoperative
Postoperative
＊P<0.05 80
＊
＊
70
＊ oo
f
60
epr
50
al rn Jo u
30 20
Pr
40
10 0
Low back pain
Leg pain
Leg numbness
Figure 2. Mean preoperative and postoperative VAS scores in the DS group
Preoperative
Postoperative
＊P<0.05 70
＊ ＊
60
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f
＊ epr
50
Pr
40
rn Jo u
20
al
30
10 0
Low back pain
Leg pain
Leg numbness
Figure 3. Mean preoperative and postoperative VAS scores in the SS group
Abbreviations
DOI: Degree of improvement DS: Degenerative lumbar spondylolisthesis E (group): Effective (group) I (group): Ineffective (group) IOI: Intensity of improvement
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JOABPEQ: Japanese Orthopaedic Association Back Pain Evaluation Questionnaire
MED: Microendoscopic decompression
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SS: Lumbar spinal stenosis
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MCID: Minimal clinically important difference
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na
lP
VAS: Visual analogue scale
Jo
ro
LBP: Low back pain
OBJECTIVE: To determine whether preoperative presence of degenerative lumbar spondylolisthesis (DS) worsens the minimum 10-year outcome of patients undergoing microendoscopic decompression (MED) for lumbar spinal stenosis (SS). METHODS: Eighty patients undergoing MED were classified into two groups: DS group (34 SS with DS patients) and SS group (46 SS without DS patients). The degrees of improvement (DOIs) by the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and intensities of improvement (IOIs) by visual analogue scale (VAS) at 120~159 (mean, 138.4) months after MED of the DS and SS groups were statistically compared. Patients with DS were classified into two groups based on the effectiveness by VAS or JOABPEQ: effective group (E group: IOI or DOI ≥20) and ineffective group (I group).
of
All preoperative radiological measurements were statistically compared between the E and I
ro
groups.
RESULTS: Significant decreases in low back pain (LBP), leg pain and numbness, as
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measured by VAS, were noted at follow-up in the DS and SS groups. The effectiveness rates
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of pain-related disorders, lumbar spine dysfunction, and gait disturbance by JOABPEQ were almost equally high in the DS and SS groups. Statistical comparisons of the DOIs in all five
lP
functional scores and IOIs in LBP, leg pain and numbness showed no significant differences between the DS and SS groups. No significant differences were confirmed between the E and
na
I groups concerning preoperative spondylolisthesis and instability. CONCLUSIONS: Our study indicated that preoperative DS did not worsen the outcome of
Jo
ur
patients with SS undergoing MED.
Declaration of interests ☒ The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
☐ The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:
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lP
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Declarations of interest: none