General Session: MIS - Hall F
Presented by: B. Mayo
B. Khechen(1), B. Haws(1), A. Narain(1), F. Hijji(1), D. Massel(1), B. Mayo(1), P. Louie(1), J. Guntin(1), K. Cardinal(1), K. Singh(1)
(1) Rush University Medical Center, Orthopaedic Surgery, Chicago, IL, United States
Introduction: A minimally invasive lumbar decompression (MIS LD) is commonly performed to alleviate radicular leg pain resulting from neural compression. However, the extent to which MIS LD improves back pain remains poorly defined. The purpose of this study is to quantify the improvement in back pain, leg pain, Oswestry Disability Index (ODI), and Short Form-12 (SF-12) Mental (MCS) and Physical (PCS) Health Composite scores following a MIS LD.
Methods: A retrospective analysis of patients who underwent a primary, one-level MIS LD during 2013-2015 was reviewed. Patients were included if they underwent a discectomy, laminectomy, foraminotomy, facetectomy, or laminoforaminotomy for degenerative spinal pathology. Pairwise comparisons of preoperative to postoperative visual analogue scale (VAS) back and leg pain, ODI, and SF-12 MCS and PCS scores were performed using paired t-tests for each postoperative time point (6-weeks, 12-weeks, 6-months, and 1-year). ANOVA was used to estimate the overall reduction in back and leg pain that patients experienced over the first postoperative year. Subgroup analyses comparing the preoperative to postoperative VAS and ODI scores were performed for patients with predominant back (pBP) or leg (pLP) pain.
Results: A total of 102 patients were identified. VAS back and leg both improved from preoperative to all postoperative time points (p< 0.05 for each). On average across the first postoperative year, patients experienced a 2.8 point (47.0%) reduction in back pain and a 4.0 point (61.1%) reduction in leg pain (p< 0.05 for each). Preoperatively, 52 patients (51.0%) had pBP and 50 patients (49.0%) had pLP. In each of these cohorts, patients experienced reductions in both back and leg pain throughout the year following surgery (p< 0.05 for each). The majority of patient experienced clinically significant differences in their symptoms regardless of presenting symptom.
Conclusion: The results of this study suggest that patients experience significant improvements in their back and leg pain following a MIS LD regardless of whether they present with pBP or pLP. Patients often experience the majority of their improvement in pain and disability during the first 6-weeks following surgery and can expect a 47.0% and 61.1% reduction in their VAS back and leg pain scores over the first postoperative year.