Lumbar spinal canal stenosis in patients with diffuse idiopathic skeletal hyperostosis

Surgical outcomes after posterior decompression surgery without spinal instrumentation

Research output: Contribution to journalArticle

Abstract

Background: To evaluate surgical outcomes after posterior decompression surgery for lumbar spinal canal stenosis (LSS) in patients with diffuse idiopathic skeletal hyperostosis (DISH). Methods: The patients (n = 184; 132 males and 52 females; mean age 72.0 years; mean follow-up 30.7 months) who underwent posterior decompression surgery for LSS were identified and classified as either DISH (D) or non-DISH (N) based on whole spine radiograph findings. Data on age, gender, American Society of Anesthesiologists (ASA) classification, operation time, and estimated blood loss, were evaluated, while radiographic parameters were measured from radiographs obtained pre- and post-operatively. Results: Mean age and ASA classification were comparable between the two groups, while the proportion of males was significantly higher in the D group (87.5%) than in the N group (67.6%) (p = 0.016). Further, mean operation time was longer in the D group (89.0 min) than in the N group (73.7 min) (p = 0.036) and mean estimated blood loss was larger in the D group (98.7 g) than in the N group (51.9 g) (p = 0.006). At two years after surgery, the development of anterior translation was significantly higher in the D group (33.3%) than in the N group (17.3%) (p = 0.021). Improvements in ODI and SF-8 after the surgery were better in the N group than in the D group. Conclusions: Compared to LSS patients without DISH who also underwent posterior decompression surgery for LSS, surgery in patients with DISH was characterized by greater blood loss, longer operation time, increased translation at the decompressed segment, and poor recovery.

Original languageEnglish
JournalJournal of Orthopaedic Science
DOIs
Publication statusAccepted/In press - 2019 Jan 1

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Diffuse Idiopathic Skeletal Hyperostosis
Spinal Stenosis
Spinal Canal
Decompression
Hyperostosis
Spine

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

@article{38b64a1c2e1741c6bcfb148f06479564,
title = "Lumbar spinal canal stenosis in patients with diffuse idiopathic skeletal hyperostosis: Surgical outcomes after posterior decompression surgery without spinal instrumentation",
abstract = "Background: To evaluate surgical outcomes after posterior decompression surgery for lumbar spinal canal stenosis (LSS) in patients with diffuse idiopathic skeletal hyperostosis (DISH). Methods: The patients (n = 184; 132 males and 52 females; mean age 72.0 years; mean follow-up 30.7 months) who underwent posterior decompression surgery for LSS were identified and classified as either DISH (D) or non-DISH (N) based on whole spine radiograph findings. Data on age, gender, American Society of Anesthesiologists (ASA) classification, operation time, and estimated blood loss, were evaluated, while radiographic parameters were measured from radiographs obtained pre- and post-operatively. Results: Mean age and ASA classification were comparable between the two groups, while the proportion of males was significantly higher in the D group (87.5{\%}) than in the N group (67.6{\%}) (p = 0.016). Further, mean operation time was longer in the D group (89.0 min) than in the N group (73.7 min) (p = 0.036) and mean estimated blood loss was larger in the D group (98.7 g) than in the N group (51.9 g) (p = 0.006). At two years after surgery, the development of anterior translation was significantly higher in the D group (33.3{\%}) than in the N group (17.3{\%}) (p = 0.021). Improvements in ODI and SF-8 after the surgery were better in the N group than in the D group. Conclusions: Compared to LSS patients without DISH who also underwent posterior decompression surgery for LSS, surgery in patients with DISH was characterized by greater blood loss, longer operation time, increased translation at the decompressed segment, and poor recovery.",
author = "Eijiro Okada and Mitsuru Yagi and Nobuyuki Fujita and Satoshi Suzuki and Osahiko Tsuji and Narihito Nagoshi and Masaya Nakamura and Morio Matsumoto and Koota Watanabe",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.jos.2019.08.010",
language = "English",
journal = "Journal of Orthopaedic Science",
issn = "0949-2658",
publisher = "Springer Japan",

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TY - JOUR

T1 - Lumbar spinal canal stenosis in patients with diffuse idiopathic skeletal hyperostosis

T2 - Surgical outcomes after posterior decompression surgery without spinal instrumentation

AU - Okada, Eijiro

AU - Yagi, Mitsuru

AU - Fujita, Nobuyuki

AU - Suzuki, Satoshi

AU - Tsuji, Osahiko

AU - Nagoshi, Narihito

AU - Nakamura, Masaya

AU - Matsumoto, Morio

AU - Watanabe, Koota

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: To evaluate surgical outcomes after posterior decompression surgery for lumbar spinal canal stenosis (LSS) in patients with diffuse idiopathic skeletal hyperostosis (DISH). Methods: The patients (n = 184; 132 males and 52 females; mean age 72.0 years; mean follow-up 30.7 months) who underwent posterior decompression surgery for LSS were identified and classified as either DISH (D) or non-DISH (N) based on whole spine radiograph findings. Data on age, gender, American Society of Anesthesiologists (ASA) classification, operation time, and estimated blood loss, were evaluated, while radiographic parameters were measured from radiographs obtained pre- and post-operatively. Results: Mean age and ASA classification were comparable between the two groups, while the proportion of males was significantly higher in the D group (87.5%) than in the N group (67.6%) (p = 0.016). Further, mean operation time was longer in the D group (89.0 min) than in the N group (73.7 min) (p = 0.036) and mean estimated blood loss was larger in the D group (98.7 g) than in the N group (51.9 g) (p = 0.006). At two years after surgery, the development of anterior translation was significantly higher in the D group (33.3%) than in the N group (17.3%) (p = 0.021). Improvements in ODI and SF-8 after the surgery were better in the N group than in the D group. Conclusions: Compared to LSS patients without DISH who also underwent posterior decompression surgery for LSS, surgery in patients with DISH was characterized by greater blood loss, longer operation time, increased translation at the decompressed segment, and poor recovery.

AB - Background: To evaluate surgical outcomes after posterior decompression surgery for lumbar spinal canal stenosis (LSS) in patients with diffuse idiopathic skeletal hyperostosis (DISH). Methods: The patients (n = 184; 132 males and 52 females; mean age 72.0 years; mean follow-up 30.7 months) who underwent posterior decompression surgery for LSS were identified and classified as either DISH (D) or non-DISH (N) based on whole spine radiograph findings. Data on age, gender, American Society of Anesthesiologists (ASA) classification, operation time, and estimated blood loss, were evaluated, while radiographic parameters were measured from radiographs obtained pre- and post-operatively. Results: Mean age and ASA classification were comparable between the two groups, while the proportion of males was significantly higher in the D group (87.5%) than in the N group (67.6%) (p = 0.016). Further, mean operation time was longer in the D group (89.0 min) than in the N group (73.7 min) (p = 0.036) and mean estimated blood loss was larger in the D group (98.7 g) than in the N group (51.9 g) (p = 0.006). At two years after surgery, the development of anterior translation was significantly higher in the D group (33.3%) than in the N group (17.3%) (p = 0.021). Improvements in ODI and SF-8 after the surgery were better in the N group than in the D group. Conclusions: Compared to LSS patients without DISH who also underwent posterior decompression surgery for LSS, surgery in patients with DISH was characterized by greater blood loss, longer operation time, increased translation at the decompressed segment, and poor recovery.

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U2 - 10.1016/j.jos.2019.08.010

DO - 10.1016/j.jos.2019.08.010

M3 - Article

JO - Journal of Orthopaedic Science

JF - Journal of Orthopaedic Science

SN - 0949-2658

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