Factors Associated with the Effect of Conservative Treatment in Surgically Indicated Single-Level Lumbar Spinal Stenosis Patient (수술이 필요한 단분절 요추부 척추관 협착증 환자에서 보존적 치료 효과와 연관된 인자)

Young-Joon Ahn (안영준); 임세혁; Seok-In Jang (장석인)

Factors Associated with the Effect of Conservative Treatment in Surgically Indicated Single-Level Lumbar Spinal Stenosis Patient

Journal of Korean Society of Spine Surgery
Abbr : J Kor Spine Sur
2019, 26(4), pp.151-159
Publisher : Korean Society Of Spine Surgery
Research Area : Medicine and Pharmacy > Orthopedic Surgery
Published : December 31, 2019

Young-Joon Ahn ¹, 임세혁 ², Seok-In Jang ¹

¹국립경찰병원 정형외과
²국립경찰병원 정형외과학교실

Accredited

ABSTRACT

Study Design: Retrospective study of date collected prospectively. Objectives: To report analytic results about association factors related to effect of conservative treatment in surgically indicated single level lumbar spinal stenosis patient. Summary of Literature Review: There have been various reports about clinical outcomes and relative factors after surgical treatment of spinal stenosis. However, there are few reports about factors related to effect of conservative treatment in surgically indicated lumbar spinal stenosis patient. Materials and Methods: We based on 40 patients who had visited our hospital from May 2010 to April 2016 who were traceable for at least three years. We analysed 20 patients who improved symptom and who didn’t improved symptom then investigated association factors related to effect of conservative treatment. Clinical assessment was conducted using questionnaire and spinal canal’s area and muscle amount were measured in the MRI. Results: Average of the spinal canal of not-improved group is 91.29(±34.26) mm2, improved group is 130.70 (±32.18) mm2 and impoved group is wider (p=0.001). Muscle mass of improved group is 91.47(±9.43) cm2, not-improved group is 79.26 (±14.35) cm2, and improved group is wider (p=0.003). Repetitive strain and traffic accident were related in not-improved group (p=0.028). However, practiced stretching continuously were related to symptom improvement (p=0.022). Conclusions: Association factors related to effect of conservative treatment are cases of wide spinal canal, wide muscle amount, repetitive sprain, traffic accident and stretching. A small muscle amount can be considered as a key factor related to surgical conversion. Key words: Lumbosacral region, Spinal stenosis, Paraspinal muscle

KEYWORDS

Lumbosacral region, Spinal stenosis, Paraspinal muscle

Citation status

* References for papers published after 2023 are currently being built.

[journal] Jeffrey N. Katz / 2008 / Lumbar Spinal Stenosis / New England Journal of Medicine / Massachusetts Medical Society 358(8) : 818~825

[journal] Yuyu Ishimoto / 2019 / The Impact of Lumbar Spinal Stenosis, Knee Osteoarthritis, and Loss of Lumbar Lordosis on the Quality of Life: Findings from the Katsuragi Low Back Pain Study / Spine Surgery and Related Research / Japanese Society for Spine Surgery and Related Research 3(2) : 157~162

[journal] Antti Malmivaara / 2007 / Surgical or Nonoperative Treatment for Lumbar Spinal stenosis? A Randomized Controlled Trial / Spine 32(1) : 1~8

[journal] Ko Matsudaira / 2016 / Predictive Factors for Subjective Improvement in Lumbar Spinal Stenosis Patients with Nonsurgical Treatment: A 3-Year Prospective Cohort Study / PLOS ONE / Public Library of Science (PLoS) 11(2) : e0148584~

[journal] Chang Hoon Jeon / 2006 / Validation in the Cross-Cultural Adaptation of the Korean Version of the Oswestry Disability Index / Journal of Korean Medical Science / 대한의학회 21(6) : 1092~1097

[journal] 심대무 / 2008 / Analysis and Measurement of the Lumbar Spinal CanalDimension using Magnetic Resonance Imaging / 대한정형외과학회지 / 대한정형외과학회 43(5) : 588~594

[journal] WAN Q / 2015 / MRI assessment of paraspinal muscles in patients with acute and chronic unilateral low back pain / Br J Radiol 88(1053) : 20140546~

[journal] Fabio Zaina / 2016 / Surgical Versus Nonsurgical Treatment for Lumbar Spinal Stenosis / SPINE / Ovid Technologies (Wolters Kluwer Health) 41(14) : E857~E868

[journal] Porter RW / 1978 / Measurement of the spinal canal by diagnostic ultrasound / J Bone Joint Surg Br 60-B(4) : 481~484

[journal] 안영준 / 2017 / Short-Term Effects of Selective Nerve Root Block in Spinal Stenosis Patients According to Spinal Canal Dimensions / 대한척추외과학회지 / 대한척추외과학회 24(2) : 72~79

[journal] Hides JA / 1994 / Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute low back pain / Spine 19(2) : 165~172

[journal] Hodges PW / 2006 / Rapid atrophy of the lumbar multifidus follows experimental disc or nerve root injury / Spine 31(25) : 2926~2933

[journal] Boutin RD / 2015 / Sarcopenia: Current Concepts and Imaging Implications / AJR Am J Roentgenol 205(3) : W255~W266

[journal] Twomey L / 1995 / Exercise and spinal manipulation in the treatment of low back pain / Spine 20(5) : 615~619

[journal] Saal JA / 1989 / Nonoperative treatment of herniated lumbar intervertebral disc with radiculopathy. An outcome study / Spine 14(4) : 431~437

[journal] Julie Hides / 2008 / Effect of Stabilization Training On Multifidus Muscle Cross-sectional Area Among Young Elite Cricketers With Low Back Pain / Journal of Orthopaedic & Sports Physical Therapy / Journal of Orthopaedic & Sports Physical Therapy (JOSPT) 38(3) : 101~108

[journal] Hides JA / 2001 / Long-term effects of specific stabilizing exercises for first-episode low back pain / Spine 26(11) : E243~E248

[journal] Mannion AF / 2001 / Active therapy for chronic low back pain. part 1. Effects on back muscle activation, fatigability, and strength / Spine 26(8) : 920~929

[journal] Videman T / 2007 / The effects of anthropometrics, lifting strength, and physical activities in disc degeneration / Spine 32(13) : 1406~1413

[journal] Callaghan JP / 1998 / The relationship between lumbar spine load and muscle activity during extensor exercises / Phys Ther 78(1) : 8~18

[journal] Elliott JM / 2006 / Fatty infiltration in the cervical extensor muscles in persistent whiplashassociated disorders. a magnetic resonance imaging analysis 31(22) : E847~E855

[journal] Per Wessberg / 2017 / Central lumbar spinal stenosis: natural history of non-surgical patients / European Spine Journal / Springer Science and Business Media LLC 26(10) : 2536~2542

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