Surgical Outcome of Degenerative Spinal Stenosis - Clinical Correlation of Patient Satisfaction and Surgical Results -

Joo-Hee Han; Jae-Lim Cho; Ye-Soo Park; Chang-Nam Kang; Yong-Hyun Choi

doi:10.4184/jkss.2001.8.1.21

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Han, Cho, Park, Kang, and Choi: Surgical Outcome of Degenerative Spinal Stenosis - Clinical Correlation of Patient Satisfaction and Surgical Results -

Original Article

Journal of Korean Spine Surg 2001;8(1):21-26.

Published online: 12 February 2001

DOI: https://doi.org/10.4184/jkss.2001.8.1.21

Surgical Outcome of Degenerative Spinal Stenosis - Clinical Correlation of Patient Satisfaction and Surgical Results -

Joo-Hee Han, M.D., Jae-Lim Cho, M.D., Ye-Soo Park, M.D., Chang-Nam Kang, M.D., Yong-Hyun Choi, M.D.

Department of Orthopaedic Surgery, College of Medicine, Hanyang University, Seoul, Korea

Address reprint requests to Jae-Lim Cho, M.D. Department of Orthopaedic Surgery, College of Medicine, Hanyang University #17, Haengdang-dong, Sungdong-gu, Seoul, Korea Tel : 82-2-2290-8485, Fax : 82-2-2299-3774, E-mail : ChoJL@email.hanyang.ac.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

This study is a retrospective evaluation of the surgical outcome by the patient satisfaction and Oswestry low back pain questionnaire.

Objective

The goal of this study was to evaluate the clinical correlations of various factors with the patient's satisfaction and with the surgical results in degenerative spinal stenosis.

Summary of Literature Review

The patients satisfaction and surgical outcome of the degenerative spinal stenosis by the objective method have not been well described in the literature.

Material and Methods

Mean follow- up period was 4.8 years after surgery in 114 patients. Outcome was based on subjective disability using Oswestry low back pain questionnaire. Patient satisfaction degree was rated to ‘very satisfied(1)’, ‘somewhat satisfied(2)’, ‘somewhat dissatisfied(3)’ and ‘very dissatisfied(4)’. Several factors that might be associated with patient satisfaction and outcome were investigated.

Results

Of the one hundred and fourteen patients, 84(73.9%) were satisfied to the surgery and mean satisfaction degree was 1.94. Ninety two patients(80.7%) had excellent- to- good results with the mean Oswestry disability score 26.9. There were 7 complications including dural tear in 3 cases, pseudarthrosis in 1 case, dissociation between rod and screw in 1 case, pedicle screw breakage in 1 case and termination of operatin due to massive bleeding during operation in 1 case.

Conclusion

Clinical results and patient satisfaction were better in the cases with short segments fusion than long segments fusion and the patients with preoperative leg symptom as major symptom had significantly lower Oswestry disability score.

Keywords: Lumbar spine, Degenerative spinal stenosis, Surgical outcome, Oswestry questionnaire, Satisfaction

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Table 1.

Satisfaction degree

Satisfaction degree	No. of Pt. (%)
very satisfied(1)	45 (39.5 %)
Somewhat satisfied(2)	39 (34.2 %)	73.7 %
Somewhat dissatisfied(3)	22 (19.3 %)
Very dissatisfied(4)	8 (7.0 %)	26.3 %

Table 2.

Clinical result by Oswestry score

Disability score	No. of Pt. (%)
Excellent(0-20)	52 (45.6 %)
Good(21-40)	40 (35.1 %)	80.7 %
Fair(41-60)	12 (10.5 %)
Poor(>60)	10 (8.8 %)	19.3 %

Table 3.

Results of various factors

	Male(45)	Sex Female(8)	p-value	<50 yrs	Age >50 yrs	p-value	Yes(7)	Complication No(107) p	p-value
Satisfaction degree	1.80	1.98	0.38	1.87	1.99	0.312	1.86	1.94	0.876
Oswestry score	22.60	28.08	0.256	25.27	27.93	0.515	31.86	28.55	0.524
Fusion segments Short^∗(57) Long#(57) p-value				Postoperative symptoms No(62) Yes(52) p-value			Concomitant systemic disease No(74) Yes(44) p-value
Satisfaction degree	1.77	2.11	0.024	1.61	2.33	0.0001	1.80	2.00	0.893
Oswestry score	21.82	31.93	0.010	20.5	34.5	0.001	27.4	26.5	0.812

^∗ less than 2 segments, # more than 3 segments

Table 4.

Change of preoperative symptoms

Preoperative symptoms	Postoperative symptoms
Back pain (30)	none(14)
	back pain(12)
	leg pain(1)
	miscellaneous(3)
Leg pain (40)	none(26)
	back pain(6)
	leg pain(6)
	miscellaneous(2)
Back and leg pain (44)	none(22)
	back pain(8)
	leg pain(3)
	back and leg pain(6)
	miscellaneous(5)

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