Journal List > J Korean Soc Spine Surg > v.8(1) > 1035944

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

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.

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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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