J Korean Soc Spine Surg.  2019 Dec;26(4):151-159. 10.4184/jkss.2019.26.4.151.

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

• Ahn YJ
• Im SH
• Jang SI

• KMID: 2467944
• DOI: http://doi.org/10.4184/jkss.2019.26.4.151

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.

Keyword

Lumbosacral region; Spinal stenosis; Paraspinal muscle

MeSH Terms

Accidents, Traffic
Humans
Lumbosacral Region
Magnetic Resonance Imaging
Paraspinal Muscles
Prospective Studies
Retrospective Studies
Spinal Canal
Spinal Stenosis*
Sprains and Strains

Figure

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  Fig. 1. Flow of the patients through each stage of the study.

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  Fig. 2. We measured the spinal canal dimension using free line ROI cal-culator calculator.

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  Fig. 3. We measured the paraspinal muscles using free line ROI calcula-tor calculator. M1: psoas major, M2: quadrates lumborum, M3: erector spinae, M4: multifidus.

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