Frank Beyer1, Fabian Geier2, Jan Bredow2, Johannes Oppermann2, Andreas Schmidt1, Peer Eysel2, Rolf Sobottke3. 1. Department of Orthopedic and Trauma Surgery, Marien Krankenhaus GmbH, Bergisch Gladbach, Germany. 2. Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany. 3. Department of Orthopedic and Trauma Surgery, Medizinisches Zentrum StädteRegion Aachen GmbH, Mauerfeldchen, Würselen, Germany.
Abstract
BACKGROUND AND OBJECTIVE: Non-operative treatment is widely accepted for early stages of lumbar spinal stenosis. In general, a trial of conservative treatment is recommended prior to surgery. However, there is an ongoing debate regarding benefits from non-operative treatment and their duration. METHODS: Thirty-eight patients were included in this prospective study. All patients received repeated epidural injections and facet joint injections as well as physiotherapy during a one week hospitalization. Patient characteristics, VAS scores, COMI and ODI scores and SF-36 were assessed prior to and immediately after treatment as well as after six, twelve, and 26 weeks. For six weeks after treatment, patients were asked to record a pain diary. RESULTS: Back and leg pain scores improved significantly on VAS up to three months follow-up. COMI score improved significantly over the entire follow-up. Regarding quality of life, mental sub-scores showed no improvement. Physical component summary scores improved for the first three months. CONCLUSIONS: Non-operative treatment offers pain relief and improves physical function for three months. COMI scores improve up to six months follow-up. Spine Tango registry offers standardized instruments for outcome evaluation of non-operative treatment.
BACKGROUND AND OBJECTIVE: Non-operative treatment is widely accepted for early stages of lumbar spinal stenosis. In general, a trial of conservative treatment is recommended prior to surgery. However, there is an ongoing debate regarding benefits from non-operative treatment and their duration. METHODS: Thirty-eight patients were included in this prospective study. All patients received repeated epidural injections and facet joint injections as well as physiotherapy during a one week hospitalization. Patient characteristics, VAS scores, COMI and ODI scores and SF-36 were assessed prior to and immediately after treatment as well as after six, twelve, and 26 weeks. For six weeks after treatment, patients were asked to record a pain diary. RESULTS: Back and leg pain scores improved significantly on VAS up to three months follow-up. COMI score improved significantly over the entire follow-up. Regarding quality of life, mental sub-scores showed no improvement. Physical component summary scores improved for the first three months. CONCLUSIONS: Non-operative treatment offers pain relief and improves physical function for three months. COMI scores improve up to six months follow-up. Spine Tango registry offers standardized instruments for outcome evaluation of non-operative treatment.
Authors: Oluwatobi O Onafowokan; Nicola F Fine; Francis Brooks; Oliver M Stokes; Timothy Wr Briggs; Mike Hutton Journal: Eur Spine J Date: 2020-01-01 Impact factor: 3.134