Article Figures & Data
Tables
Total number of eligible patients with foraminal claudication 79 Entire Cohort Age at 10 year review (years) Mean ±SD 56 ± 10.5 Range 40–82 Duration of symptoms (years) Mean ±SD 10.1 ± 4.9 Range 3–29 Males 37 Predominant presenting activity related symptom(s)* Back pain predominating over leg symptoms 42 Predominant buttock, groin or proximal limb pain & weakness 12 Predominant limb pain extending below the knee 15** Equivalent predominance of back, buttock and limb pain 6 Bilateral or oscillating limb pain 4 Interventional Level L1-2 0 L2-3 1 L3-4 3 L4-5 or Transitional 35 L5-S1 or Transitional 40 Predominant Pathology Combinations Disc protrusion & axial stenosis & foraminal narrowing 37 Spondylolisthesis & foraminal narrowing 12 Perineural scarring ± osteophytosis 14 Foraminal & lateral recess stenosis 10 Pedicle wall fragmentation compromising the foramen 1 Cage implant foraminal compromise 2 Retrolisthesis & foraminal compromise 3 Prior pain management Chronic pain management 62 Coping courses 42 Residential cognitive behavioural therapy 24 Eligible for dorsal column stimulator 9 Discectomy Group 26 1 Level laminectomy and discectomy 2 2 Levels laminectomy and discectomy 3 3 Levels laminectomy and discectomy 1 Laminectomy revisions by microdiscectomy 1 Laminectomy revisions by Fusion 3 1 Level microdiscectomy 10 2 Levels microdiscectomy 5 Microdiscectomy revisions by microdiscectomy 1 Microdiscectomy revisions by stenosis decompression 4 Microdiscectomy revisions by fusion 3 Primary axial “Decompression” & discectomy 2 Primary lateral recess “Decompression” & discectomy 3 Primary Fusion Group 13 1 Level posterior lumbar interbody fusion 5 2 Level posterior lumbar interbody fusion 4 1 Level anterior lumbar interbody fusion 2 2 Level anterior lumbar interbody fusion 1 2 Level posterolateral instrumented fusion 2 2 Level Graf Ligament fusion 1 Patients Percentage of Stenotic Cohort Good & Excellent Clinical Impact & Satisfactory Good & Excellent Clinical Impact Excellent 28 35.4% 82.2% 72.1% Good 29 36.7% Satisfactory 8 10.1% Poor 11 13.9% Worse 3 3.8% - Table 4
Comparison of Mean VAS and ODI scores prior to surgery and at 10 years postoperatively.
Preoperative VAS Post-Operative VAS % Change Mean 7.3 2.4 67% S.D 1.8 2.1 Preoperative ODI Post-Operative ODI % Change Mean 58.5 17.5 70% S.D 14.7 15.2 VAS = Visual Analogue Pain Score, ODI = Oswestry Disability Index.
Working Age Retired Preoperative Prolo score Post-Operative Prolo score Preoperative Prolo score Post-Operative Prolo score Mean 3.4 1.7 3.6 1.9 S.D 0.9 0.8 0.8 1.0 Level 1 0 22 0 18 Level 2 5 15 2 6 Level 3 20 5 17 10 Level 4 12 1 11 2 Level 5 6 0 6 0 Prolo Definitions: 1) Able to work at previous occupation or full retirement activity with no restriction of any kind; 2) Working at previous occupation or retirement activity on part-time or limited status; 3) Able to work or pursue retirement activity but not at previous occupation or retirement activity levels; 4) No gainful occupation or retirement activity (able to do housework or limited self help activities); 5) Invalid (unable to cope with self-help activities without help)
Recurrent operative site symptoms 2 Stenosis 2 Concurrent Perineural Scarring 1 Contra-lateral same level stenosis 3 Adjacent level deterioration 6 Disc Protrusion 2 Degenerative Spondylolisthesis 2 Foraminal Stenosis 2 Self-excluded to physical review Multiple Sclerosis 1 Ovarian Cancer & Fusion 1 Sequelae of Fusion 2 FBS Group Preoperative VAS Review VAS Preoperative ODI Review ODI Mean 7.6 2.2 60.8 16.3 S.D 1.9 2.0 15.3 14.7 Primary Surgery Preoperative VAS Review VAS Preoperative ODI Review ODI Mean 7.0 2.6 56.3 18.6 S.D 1.7 2.2 13.9 15.8
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