COMPUTED-TOMOGRAPHY AFTER LAMINECTOMY FOR LUMBAR SPINAL STENOSIS - PATIENTS PAIN PATTERNS, WALKING CAPACITY, AND SUBJECTIVE DISABILITY HAD NO CORRELATION WITH COMPUTED-TOMOGRAPHY FINDINGS

被引:49
作者
HERNO, A
AIRAKSINEN, O
SAARI, T
机构
[1] Department of Physical Medicine and Rehabilitation, Kuopio University Hospital, Kuopio
[2] Department of Clinical Radiology, Kuopio University Hospital, Kuopio
关键词
COMPUTED TOMOGRAPHY; FAILED BACK SURGERY; LAMINECTOMY; LUMBAR SPINAL STENOSIS;
D O I
10.1097/00007632-199409000-00019
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objectives. The purpose of this study was to evaluate the relationship between postoperative computed tomography findings and patients' pain patterns, walking capacity, and subjective disability after laminectomy for lumbar spinal stenosis. Summary of Background Data. Recent improvements in computed tomography have enabled this tool to reveal changes in a patient after an operation, but there is a paucity of comparative examinations regarding the lumbar spinal canal of asymptomatic and symptomatic patients after laminectomy for lumbar spinal stenosis. Methods. Ninety-two patients (42 women, and 50 men) with a mean age of 55 years were operated upon. Mean follow-up time was 3.5 years. Based on computed tomography findings of the operative area, three patient groups were formed: 1) no stenosis, 2) moderate stenosis, 3) and severe stenosis. During treadmill testing, each patient's pain was evaluated by visual analogue scale. The patients were divided into four pain pattern groups: 1) pain in the back and leg, 2) pain in the back only, 3) pain in the leg only, and 4) no pain in the back and leg. Subjective disability was measured by the Oswestry disability score. Results. The structural changes revealed by computed tomography, and the patients' pain patterns, walking capacity, and subjective disability did not correlate significantly with each other. Conclusions. Postoperative computed tomography has only limited value because asymptomatic and symptomatic patients yield similar findings after surgery for lumbar spinal stenosis.
引用
收藏
页码:1975 / 1978
页数:4
相关论文
共 27 条
[1]  
Biondi J., Greenberg B.J., Redecompression and fusion in failed back syndrome patients, Journal of Spinal Disorders, 3, pp. 362-369, (1990)
[2]  
Braun I.F., Lin J.P., Benjamin M.V., Kricheff I.I., Computed tomography of the asymptomatic postsurgical lumbar spine: Analysis of the physiologic scar, AJR am J Roentgenol, 142, pp. 149-152, (1984)
[3]  
Burton C.V., Kirkaldy-Willis W.H., Yong-Hing K., Heithoff K.B., Causes of failure of surgery on the lumbar spine, Clin Orthop, 157, pp. 191-199, (1981)
[4]  
Byrd S.E., Cohn M.L., Biggers S.L., Huntington C.T., Locke G.E., Charles M.F., The radiographic evaluation of the symptomatic postoperative lumbar spine patient, Spine, 11, pp. 652-661, (1985)
[5]  
Carroll S.E., Wiesel S.W., Neurologic complications and lumbar laminectomy. A standardized approach to the multiply- operated lumbar spine, Clin Orthop, 284, pp. 14-23, (1992)
[6]  
Cervellini P., Curri D., Volpin L., Bernardi L., Pinna V., Benedetti A., Computed tomography of epidural fibrosis after discectomy, A Comparison between Symptomatic and Asymptomatic Patients. Neurosurgery, 23, pp. 710-713, (1988)
[7]  
Fairbank J., Couper J., Davies J.B., O'Brien J.P., The Oswestry low back pain disability questionnaire, Physiotherapy, 66, pp. 271-273, (1980)
[8]  
Heithoff K.B., Burton C.V., CT evaluation of the failed back surgery syndrome, Orthop Clin North Am, 16, pp. 417-444, (1985)
[9]  
Jalovaara P., Lahde S., Iikko E., Niinimaki T., Puranen J., The significance of residual stenosis after decompression for lumbar spinal stenosis, Ann Chir, 78, pp. 304-308, (1989)
[10]  
Johnsson K.-E., Willner S., Petterson H., Analysis of operated cases with lumbar spinal stenosis, Acta Orthop Scand, 52, pp. 427-433, (1981)