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Lumbar spinal steno...
Lumbar spinal stenosis : Body mass index and the patient's perspective
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- Knutsson, Björn (författare)
- Uppsala universitet,Ortopedi
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- Michaëlsson, Karl, Professor (preses)
- Uppsala universitet,Institutionen för kirurgiska vetenskaper
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- Sandén, Bengt, Docent (preses)
- Uppsala universitet,Institutionen för kirurgiska vetenskaper
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- Sjödén, Göran, Docent (preses)
- Institutionen för kirurgisk och perioperativ vetenskap; Umeå Universitet
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- Gerdhem, Paul, Associate professor (opponent)
- Department of Ortopaedics, Karolinska University Hospital and Department of Ortopedics and Biotechnology, Karolinska Institutet
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(creator_code:org_t)
- ISBN 9789155493769
- Uppsala : Acta Universitatis Upsaliensis, 2015
- Engelska 70 s.
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Serie: Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, 1651-6206 ; 1148
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Abstract
Ämnesord
Stäng
- During recent decades, lumbar spinal stenosis (LSS) has become the most common indication for spine surgery, a change that coincides with a higher worldwide prevalence of overweight and obesity. Thus, surgical treatment of LSS in the overweight and obese population is common and increasing in scope.The overall aim of this thesis was to investigate whether body mass index (BMI) is related to the development of LSS, and whether BMI is linked to outcome after surgery for LSS. We further evaluated whether there are specific experiences of LSS from a patient perspective.Data were obtained for all patients registered in the Swedish Spine Register who had undergone surgery for LSS between January 1, 2006 and June 30, 2008. After adjusting for differences in baseline characteristics, patients with obesity showed both poorer results after surgery and a higher rate of dissatisfaction than patients with normal weight (odds ratio 1.73; 95% confidence interval, CI, 1.36-2.19).Furthermore, patients with obesity in the cohort reported modest weight loss at follow-up (2.0 kg; 95% CI, 1.5-2.4), and only 8% reported a clinical important weight loss 2 years after surgery.Our analysis of 389,132 construction workers, showed that overweight (incidence rate ratio, IRR 1.68; 95% CI, 1.54-1.83) and obesity (IRR 2.18; 95% CI, 1.87-2.53) were associated with an increased future risk in developing LSS when compared with patients with normal weight.To gain insight into the patients' perspective of LSS, we performed interviews with 18 patients who were on a waiting list for LSS surgery. The transcripts, analyzed with content analysis, revealed that living with LSS is a physical, mental and social challenge in which resources to cope with the condition are of major importance.In summary, obesity is associated with poorer results after surgery, and patients with obesity report modest weight loss during follow-up. In addition, obesity is associated with an increased risk to develop LSS. Our findings revealed that being a patient with LSS, naturally involves considerable suffering and pain, but it also implies being a person with his or her own resources who is able to cope with these adverse conditions.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)
Nyckelord
- Antonovsky
- back pain
- BMI
- body mass index
- Bygghalsan
- cohort study
- coping
- EQ-5D
- excess weight
- leg pain
- LSS
- lumbar spinal stenosis
- obesity
- ODI Oswestry disability index
- overweight
- patient-centered
- patient-physician relationship
- patient-perspective
- patient-related-outcome-measure
- PROMs
- qualitative study
- spinal stenosis
- salutogenesis
- salutogenic
- sciatica
- spine surgery
- suffering
- Swedish spine register
- Swespine
- VAS
- weight loss
- weight change
- Orthopaedics
- Ortopedi
Publikations- och innehållstyp
- vet (ämneskategori)
- dok (ämneskategori)
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