Spinal Disease

Lumbar Spinal Disease

Surgical Treatment

Spinal stenosis results in narrowing of the spinal canal, which can lead to leg pain and impaired walking and standing. For symptomatic patients, the goal of surgery is to decompress the spinal canal to eliminate neural compression and relieve leg pain; this may or may not require instrumented fusion of the operated levels.

Change in Functional Status Following Lumbar Decompression With Fusion for Spinal Stenosis

Surgical Dates: July 3, 2017 – June 29, 2018

PDQ = Pain Disability Questionnaire, PHQ-9 = Patient Health Questionnaire, PROMIS = Patient-Reported Outcomes Measurement Information System

Among patients undergoing lumbar decompression with fusion for symptomatic spinal stenosis, 242 reported a baseline impairment of physical function (PDQ > 16); 57% noted clinically meaningful functional improvement after surgery and 10.7% worsened. Median duration of follow-up was 103 days after surgery (range, 42–468). Among patients assessed using PROMIS, 46.5% noted clinically meaningful improvement in their Physical quality of life scores and 39.6% noted clinically meaningful improvement in their Mental scores. Among 159 patients reporting at least moderate depressive symptoms (PHQ-9 ≥ 10) at baseline, 20.7% noted clinically meaningful improvement in depressive symptoms and 68.6% were stable.

Change in Functional Status Following Lumbar Decompression Without Fusion for Disc Herniation

Surgical Dates: July 3, 2017 – June 29, 2018

PDQ = Pain Disability Questionnaire, PHQ-9 = Patient Health Questionnaire, PROMIS = Patient-Reported Outcomes Measurement Information System

Among patients undergoing lumbar decompression surgery without fusion to treat severe leg pain from a lumbar disc herniation, 682 reported a baseline impairment of physical function (PDQ > 16); 60.2% noted clinically meaningful improvement after surgery and 9.9% worsened. Median duration of follow-up was 84 days after surgery (range, 32–490). Among patients assessed using PROMIS, 43.2% reported clinically meaningful improvement in their Physical quality of life scores after surgery and 29.7% reported clinically meaningful improvement in their Mental scores. Among 444 patients reporting at least moderate depressive symptoms (PHQ-9 ≥ 10) at baseline, 15.8% noted clinically meaningful improvement in depressive symptoms and 75.9% were stable.

Change in Functional Status Following Lumbar Spinal Injections for Disc Herniation

Treatment Dates: July 3, 2017 – June 28, 2018

PDQ = Pain Disability Questionnaire, PHQ-9 = Patient Health Questionnaire, PROMIS = Patient-Reported Outcomes Measurement Information System

Among patients undergoing lumbar spinal injections for severe leg pain due to a lumbar disc herniation, 28.7% noted clinically meaningful improvement in physical function after injection and 17.6% worsened. Median duration of follow-up was 119 days after injection (range, 32–567). Among patients assessed using PROMIS, 25.7% noted improvement in their Physical quality of life scores and 18.8% noted improvement in their Mental scores. Among 998 patients reporting at least moderate depressive symptoms (PHQ-9 ≥ 10) at baseline, 6.5% noted clinically meaningful improvement in depressive symptoms and 79.3% were stable.