Special Poster Session 50th International Society for the Study of the Lumbar Spine Annual Meeting 2024

Clinical Factors Associated with Patient Satisfaction Following Decompression Surgery for Lumbar Spinal Stenosis (#SP-8d)

Junichi Yamada 1 , Koji Akeda 2 , Norihiko Takegami 2 , Tatsuhiko Fujiwara 2 , Koichiro Murata 3 , Toshifumi Kono 3 , Takao Sudo 4 , Takao Imanishi 4 , Tetsushi Kondo 4 , Tatsuya Kurata 5 , Eiji Kawakita 6 , Kenji Takegami 6 , Toshihiko Sakakibara 7 , Masayoshi Sato 8 , Akihiro Sudo 2
  1. Matsusaka Municipal Hospital, Matsusaka, MIE, Japan
  2. Orthopaedic surgery, Mie university graduate school od medicine, Tsu, Japan
  3. Orthopedic surgery, Tomidahama hospital, Yokkaichi, Japan
  4. Orthopedic surgery, Murase hospital, Suzuka, Japan
  5. Orthopedic surgery, Takeuchi hospital, Tsu, Japan
  6. Orthopedic surgery, Saiseika Matsusaka General Hospital, Matsusaka, Japan
  7. Orthopedic surgery, Ise red cross hospital, Ise, Japan
  8. Orthopedic surgery, Iga city general hospital, Iga, Japan

Introduction: Lumbar spinal stenosis (LSS) is one of the most common spinal diseases causing low back pain (LBP) and leg pain. Despite the good clinical outcomes reported for the surgical treatment, a relatively high dissatisfaction rate has been reported. The purpose of this study was to identify the clinical factors including clinical outcome assessments (COAs) that reflected patient satisfaction (PS) in patients undergoing decompression surgery for LSS.

Methods: 120 men and 39 women (69.3 y/o) who underwent surgical treatment for LSS in the affiliated hospitals from March 2019 to May 2020 were subjects of this study. COAs including Japanese Orthopaedic Association (JOA) score, JOA Back Pain Evaluation Questionnaire (JOABPEQ), Visual Analogue Scale (VAS) for LBP, leg pain and numbness in the lower limbs, Oswestry Disability Index (ODI) and central sensitization inventory (CSI) were evaluated preoperatively and 12 months postoperatively. PS was assessed by five-grade evaluation. Patients who answered “very satisfied” and “satisfied” were classified into the Satisfied (S) group and those who answered “neutral”, “dissatisfied” and “very dissatisfied” were classified into the Dissatisfied (D) group. Preoperative and postoperative COAs and changes in COAs between the two groups were compared. Logistic regression analysis was performed to examine the COAs associated with PS (the S or the D group).

Results: 128 subjects were classified into the S group and 31 subjects were classified into the D group. Age, gender ratio or surgical procedure (decompression only or decompression with posterior lumbar interbody fusion) did not significantly differ between the groups. There were no significant differences between the groups in any preoperative COAs including CSI score (S: 20.8±10.6, D: 23.8±12.6). Postoperatively, all COAs in the S group were significantly better than those in the D group. While all COAs in both groups significantly improved after the surgery, changes in improvement of COAs in the D group were significantly lower than those in the S group. Logistic regression analysis showed that postoperative VAS for LBP and mental health domain of JOABPEQ, and a change in ODI were shown to be significantly associated with PS.

Discussion: The rate of PS in this study were similar to those in the previous studies. Our group previously reported that higher preoperative CSI score of the patients who underwent spinal surgery for LSS was significantly associated with worth postoperative COAs; however, this study demonstrated that postoperative LBP, mental health and change in LBP-related QOL were significantly associated with PS. Further clinical studies were required to elucidate the cause of postoperative LBP.