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Lumbar spinal steno...
Lumbar spinal stenosis : comparison of surgical practice variation and clinical outcome in three national spine registries
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- Lönne, Greger (författare)
- Innlandet Hosp Trust, Dept Orthopaed, Anders Sandvigs Gt 17, N-2629 Lillehammer, Norway;Trondheim Reg & Univ Hosp, Natl Advisory Unit Spinal Surg, St Olavs Hosp, Olav Kyrres Gate 17, N-7006 Trondheim, Norway;Northern Norway Reg Hlth Author, Norwegian Registry Spine Surg NORspine, Postboks 1445, N-8038 Bodo, Norway
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- Fritzell, Peter (författare)
- Uppsala universitet,Ortopedi,Capio St Goran Hosp, Dept Orthopaed, Sankt Goransplan 1, S-11281 Stockholm, Sweden;Stromstad Akad, Norra Bergsgatan 23, S-45280 Stromstad, Sweden;Qulturum Ctr Learning & Innovat Healthcare, Hus B4 Lanssjukhuset Ryhov, S-55305 Jonkoping, Sweden
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- Hägg, Olle (författare)
- Spine Ctr Goteborg, Gruvgatan 8, S-42130 Gothenburg, Sweden;Swedish Natl Spine Register, Swespine Steering Grp, Sveriges Kommuner & Landsting, SE-11882 Stockholm, Sweden
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- Nordvall, Dennis (författare)
- Qulturum Ctr Learning & Innovat Healthcare, Hus B4 Lanssjukhuset Ryhov, S-55305 Jonkoping, Sweden
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- Gerdhem, Paul (författare)
- Karolinska Institutet
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- Lagerbäck, Tobias (författare)
- Karolinska Institutet
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- Andersen, Mikkel (författare)
- Lillebaelt Hosp, Sect Spine Surg & Res, Ostre Hougvej 55, DK-5500 Middelfart, Denmark
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- Eiskjaer, Soren (författare)
- Aalborg Univ Hosp, Dept Orthoped Surg, Aalborg, Denmark
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- Gehrchen, Martin (författare)
- Univ Copenhagen, Rigshosp, Spine Unit, Dept Orthopaed Surg, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
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- Jacobs, Wilco (författare)
- Fraeylemastr 13, NL-2532 TX The Hague, Netherlands
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- van Hooff, Miranda L. (författare)
- Sint Maartensklin, Dept Res, Hengstdal 3, NL-6574 NA Nijmegen, Ubbergen, Netherlands;Radboud Univ Nijmegen, Dept Orthoped, Med Ctr, Geert Grootepl Zuid 10, NL-6525 GA Nijmegen, Netherlands
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- Solberg, Tore K. (författare)
- Northern Norway Reg Hlth Author, Norwegian Registry Spine Surg NORspine, Postboks 1445, N-8038 Bodo, Norway;Univ Hosp Northern Norway, Dept Neurosurg, N-9038 Tromso, Norway;Univ Tromso, Arctic Univ Norway, Inst Clin Med, Hansine Hansens Veg 18, N-9037 Tromso, Norway
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(creator_code:org_t)
- ELSEVIER SCIENCE INC, 2019
- 2019
- Engelska.
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Ingår i: The spine journal. - : ELSEVIER SCIENCE INC. - 1529-9430 .- 1878-1632. ; 19:1, s. 41-49
- Relaterad länk:
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https://vbn.aau.dk/w...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- BACKGROUND CONTEXT: Decompression surgery for lumbar spinal stenosis (LSS) is the most common spinal procedure in the elderly. To avoid persisting low back pain, adding arthrodesis has been recommended, especially if there is a coexisting degenerative spondylolisthesis. However, this strategy remains controversial, resulting in practice-based variation.PURPOSE: The present study aimed to evaluate in a pragmatic study if surgical selection criteria and variation in use of arthrodesis in three Scandinavian countries can be linked to variation in treatment effectiveness.STUDY DESIGN: This is an observational study based on a combined cohort from the national spine registries of Norway, Sweden, and Denmark.PATIENT SAMPLE: Patients aged 50 and older operated during 2011-2013 for LSS were included.OUTCOME MEASURES: Patient-Reported Outcome Measures (PROMs): Oswestry Disability Index (ODI) (primary outcome). Numeric Rating Scale (NRS) for leg pain and back pain, and health-related quality of life (Euro-QoI-5D) were reported. Analysis included case-mix adjustment. In addition, we report differences in hospital stay.METHODS: Analyses of baseline data were done by analysis of variance (ANOVA), chi-square, or logistic regression tests. The comparisons of the mean changes of PROMs at 1-year follow-up between the countries were done by ANOVA (crude) and analysis of covariance (case-mix adjustment).RESULTS: Out of 14,223 included patients, 10.890 (77%) responded at 1-year follow-up. Apart from fewer smokers in Sweden and higher comorbidity rate in Norway. baseline characteristics were similar. The rate of additional fusion surgery (patients without or with spondylolisthesis) was 11% (4%, 47%) in Norway, 21% (9%, 56%) in Sweden, and 28% (15%, 88%) in Denmark. At 1-year follow-up, the mean improvement for ODI (95% confidence interval) was 18 (17-18) in Norway, 17 (17-18) in Sweden. and 18 (17-19) in Denmark. Patients operated with arthrodesis had prolonged hospital stay.CONCLUSIONS: Real-life data from three national spine registers showed similar indications for decompression surgery but significant differences in the use of concomitant arthrodesis in Scandinavia. Additional arthrodesis was not associated with better treatment effectiveness.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)
Nyckelord
- Case-mix adjustment
- Decompressive surgery
- Lumbar spinal stenosis
- Spine arthrodesis
- Spine fusion
- Spine registry
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Lönne, Greger
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Fritzell, Peter
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Hägg, Olle
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Nordvall, Dennis
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Gerdhem, Paul
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Lagerbäck, Tobia ...
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Andersen, Mikkel
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Eiskjaer, Soren
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Gehrchen, Martin
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Jacobs, Wilco
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van Hooff, Miran ...
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Solberg, Tore K.
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Ortopedi
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The spine journa ...
- Av lärosätet
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Uppsala universitet
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Karolinska Institutet