Erynne Rowe1, Elizabeth Hassan2, Lisa Carlesso3,4, Janie Astephen Wilson1,2,5, Douglas P Gross6, Charles Fisher7, Hamilton Hall8, Neil Manson9, Ken Thomas10, Greg McIntosh11, Brian Drew5, Raja Rampersaud8, Luciana Macedo3. 1. School of Biomedical Engineering, McMaster University, Hamilton, Ontario, Canada. 2. Department of Mechanical Engineering, McMaster University, Hamilton, Ontario, Canada. 3. School of Rehabilitation Science, McMaster University, Hamilton, Canada. 4. School of Rehabilitation, Université de Montréal, Montréal, Quebec, Canada. 5. Department of Surgery, McMaster University, Hamilton, Ontario, Canada. 6. Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada. 7. Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada. 8. Department of Surgery, University of Toronto, Toronto, Ontario, Canada. 9. Canada East Spine Centre, Saint John, New Brunswick, Canada. 10. Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. 11. Canadian Spine Society, Canadian Spine Outcomes Research Network, Toronto, Ontario, Canada.
Abstract
Background: Symptomatic lumbar spinal stenosis (SLSS) is a condition in which narrowing of the spinal canal results in entrapment and compression of neurovascular structures. Decompressive surgery, with or without spinal fusion, is recommended for those with severe symptoms for whom conservative management has failed. However, significant persistent pain, functional limitations, and narcotic use can affect up to one third of patients postsurgery. Aims: The aim of this study will be to identify predictors of outcomes 1-year post SLSS surgery with a focus on modifiable predictors. Methods: The Canadian Spine Outcomes Research Network (CSORN) is a large database of prospectively collected data on pre- and postsurgical outcomes among surgical patients. We include participants with a primary diagnosis of SLSS undergoing their first spine surgery. Outcomes are measured at 12 months after surgery and include back and leg pain, disability (Oswestry Disability Index, ODI), walking capacity (ODI item 4), health-related quality of life, and an overall recovery composite outcome (clinically important changes in pain, disability, and quality of life). Predictors include demographics (education level, work status, marital status, age, sex, body mass index), physical activity level, smoking status, previous conservative treatments, medication intake, depression, patient expectations, and other comorbidities. A multivariate partial least squares model is used to identify predictors of outcomes. Conclusion: Study results will inform targeted SLSS interventions, either for the selection of best candidates for surgery or the identification of targets for presurgical rehabilitation programs.
Background: Symptomatic lumbar spinal stenosis (SLSS) is a condition in which narrowing of the spinal canal results in entrapment and compression of neurovascular structures. Decompressive surgery, with or without spinal fusion, is recommended for those with severe symptoms for whom conservative management has failed. However, significant persistent pain, functional limitations, and narcotic use can affect up to one third of patients postsurgery. Aims: The aim of this study will be to identify predictors of outcomes 1-year post SLSS surgery with a focus on modifiable predictors. Methods: The Canadian Spine Outcomes Research Network (CSORN) is a large database of prospectively collected data on pre- and postsurgical outcomes among surgical patients. We include participants with a primary diagnosis of SLSS undergoing their first spine surgery. Outcomes are measured at 12 months after surgery and include back and leg pain, disability (Oswestry Disability Index, ODI), walking capacity (ODI item 4), health-related quality of life, and an overall recovery composite outcome (clinically important changes in pain, disability, and quality of life). Predictors include demographics (education level, work status, marital status, age, sex, body mass index), physical activity level, smoking status, previous conservative treatments, medication intake, depression, patient expectations, and other comorbidities. A multivariate partial least squares model is used to identify predictors of outcomes. Conclusion: Study results will inform targeted SLSS interventions, either for the selection of best candidates for surgery or the identification of targets for presurgical rehabilitation programs.
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