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
Pages (from-to)999-1004
Number of pages6
JournalJournal of Orthopaedic Science
Volume24
Issue number6
DOIs
Publication statusPublished - 2019 Nov

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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