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Prognostic factors for surgical outcomes including preoperative total knee replacement and knee osteoarthritis status in female patients with lumbar spinal stenosis

Authors
 Byung Ho Lee  ;  Tae Hwan Kim  ;  Hyun Soo Chong  ;  Seung Hwan Lee  ;  Jin Oh Park  ;  Hak Sun Kim  ;  Dong Woo Shim  ;  Hwan Mo Lee  ;  Seong Hwan Moon 
Citation
 JOURNAL OF SPINAL DISORDERS & TECHNIQUES, Vol.28(2) : 47-52, 2015 
Journal Title
 JOURNAL OF SPINAL DISORDERS & TECHNIQUES 
ISSN
 1536-0652 
Issue Date
2015
MeSH
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/methods* ; Disability Evaluation ; Female ; Humans ; Lumbar Vertebrae/surgery* ; Middle Aged ; Osteoarthritis, Knee/complications* ; Osteoarthritis, Knee/surgery* ; Osteoporosis/complications ; Osteoporosis/pathology ; Prognosis ; Retrospective Studies ; Spinal Fusion ; Spinal Stenosis/complications* ; Spinal Stenosis/surgery* ; Treatment Outcome
Keywords
lumbar spinal stenosis ; surgery ; outcome ; knee osteoarthritis ; total knee replacement
Abstract
STUDY DESIGN: A retrospective clinical case series. OBJECTIVE: To investigate knee osteoarthritis (KOA) and total knee replacement (TKR) status as prognostic factors for surgical outcomes in female patients with lumbar spinal stenosis (LSS). SUMMARY OF BACKGROUND DATA: There have been many reports on numerous prognostic factors for surgical outcomes in patients with degenerative lumbar conditions; however, there has been no report on the surgical outcome in patients who underwent spinal surgery with coexisting KOA and TKR. METHODS: This study included 141 female patients (mean age, 67.6 y) who underwent spinal surgery for LSS between January 2006 and December 2010. At 1 year postoperatively, surgical outcomes were measured using the Oswestry disability index (ODI). Various clinical factors including KOA and TKR were analyzed as prognostic factors for surgical outcomes. RESULTS: Mean average scores at preoperative evaluation were 26.1±6.6 in the no KOA group, 23.6±7.9 in the KOA group, and 30.4±6.7 in the TKR group (P<0.05). Mean average scores at postoperative 1 year were 13.8±8.5 in the no KOA group, 16.8±9.5 in the KOA group, and 21.4±5.7 in the TKR group (P<0.05, Mann-Whitney U test). Preoperative ODI scores were shown to be significantly affected by the TKR status only (P<0.05), and were significantly higher in the TKR patient group. ODI scores at postoperative 3 months were significantly correlated with the preoperative ODI and the operational level (P<0.05). At postoperative 1 year, ODI scores were shown to be affected by the operational level, the preoperative ODI, and the presence of advanced radiographic KOA (Kellgren/Lawrence grades III and IV) (P<0.05). CONCLUSIONS: A poor preoperative functional score, the presence of preoperative KOA, and longer operational levels were shown to be poor prognostic factors for the 1-year surgical outcome of LSS. Also, patients in the TKR group showed the worst ODI scores at preoperative and postoperative 1-year evaluations. Consideration of these factors when planning for spine surgery could be helpful in predicting the surgical outcomes of lumbar spinal surgery.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00024720-201503000-00002&LSLINK=80&D=ovft
DOI
10.1097/BSD.0b013e31828d003d
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae Hwan(김태환)
Kim, Hak Sun(김학선) ORCID logo https://orcid.org/0000-0002-8330-4688
Moon, Seong Hwan(문성환)
Park, Jin Oh(박진오)
Lee, Byung Ho(이병호) ORCID logo https://orcid.org/0000-0001-7235-4981
Lee, Seung Hwan(이승환)
Lee, Hwan Mo(이환모) ORCID logo https://orcid.org/0000-0002-5405-3832
Chong, Hyon Su(정현수)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139580
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