Decompressive surgery for lumbar spinal stenosis across the Atlantic: a comparison of preoperative MRI between matched cohorts from the US and Norway

被引:3
作者
Bhalla, Amandeep [1 ]
Cha, Thomas D. [2 ]
Weber, Clemens [3 ]
Nerland, Ulf [4 ]
Gulati, Sasha [4 ,5 ]
Lonne, Greger [2 ,6 ]
机构
[1] Harvard Med Sch, Brigham & Womens Hosp, Dept Orthopaed Surg, 75 Francis St, Boston, MA 02115 USA
[2] Harvard Med Sch, Massachusetts Gen Hosp, Dept Orthopaed Surg, 55 Fruit St, Boston, MA 02214 USA
[3] Stavanger Univ Hosp, Dept Neurosurg, N-4068 Stavanger, Norway
[4] St Olavs Univ Hosp, Dept Neurosurg, Trondheim, Norway
[5] Norwegian Univ Sci & Technol, Dept Neurosci, Trondheim, Norway
[6] Innlandet Hosp Trust, Dept Orthopaed, Anders Sandvigsgate 17, N-2629 Lillehammer, Norway
关键词
Lumbar spinal stenosis; Magnetic resonance imaging; Schizas classification; Decompression; Propensity score matching; INVASIVE DECOMPRESSION; OPEN LAMINECTOMY; DECISION-MAKING; DURAL SAC; TRENDS; PAIN; DISABILITY; MORPHOLOGY; DIAGNOSIS; SEVERITY;
D O I
10.1007/s00701-017-3460-1
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
There are no uniform guidelines regarding when to operate for Lumbar Spinal Stenosis (LSS). As we apply findings from clinical research from one population to the next, elucidating similarities or differences provides important context for the validity of extrapolating clinical outcomes. The aim of this study was to compare the morphological severity of lumbar spinal stenosis on preoperative MRI in patients undergoing decompressive surgery in Boston, USA, and Trondheim, Norway. In this observational retrospective study, we compared morphological severity on MRI before surgical treatment between two propensity score-matched patient populations with single or two-level symptomatic LSS. We assessed the radiographic severity of LSS utilizing the Schizas classification (grade A to D). Following propensity score matching, demographics are balanced. In the Trondheim cohort, two levels decompression were present in 36.2% of the patients vs. 41.9% in Boston, (p = 0.396). There was no significant difference in grades A to D concerning central stenosis (p = 0.075). When dichotomized in mild/moderate (A/B) and severe /extreme (C/D), there were no significant differences in the rate of levels operated for high-grade stenosis (C/D), 67.6% in the Boston group compare to 78.1% in the Trondheim group (p = 0.088). Trondheim, Norway, and Boston, US, have similar radiographic thresholds of LSS for offering surgery.
引用
收藏
页码:419 / 424
页数:6
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