Change in Patient-Reported Outcome Measures as Predictors of Revision Lumbar Decompression Procedures

Objective: To assess change in Patient-Reported Outcome Measures (PROM) as predictors for revision lumbar decompression (LD).Methods: Patients who underwent primary, single or multilevel LD were retrospectively reviewed. Patients were categorized according to whether or not they underwent revision LD within 2 years of the primary procedure. Visual analogue scale (VAS), Oswestry Disability Index (ODI), 12-item Short Form Health Survey and 12-item Veterans RAND physical component score (SF-12 PCS and VR-12 PCS), and Patient-Reported Outcome Measurement Information System physical function (PROMIS-PF) were recorded. Delta PROM scores were evaluated for differences between groups and as a risk factor for a revision LD.Results: The study included 135 patients, 91 undergoing a primary procedure only and 44 undergoing a primary and revision procedure. Matched patients did not demonstrate any significant differences in demographics or perioperative characteristics. Patients who underwent a revision had a mean time to revision of 7.4 ± 5.7 months. Primary cohort significantly improved for all PROMs (all p < 0.05), while the primary plus revision cohort significantly improved for VAS back, ODI, and PROMIS-PF (all p < 0.05). However, cohorts differed in VAS back and PROMIS-PF (p < 0.05). Delta PROMs were not a significant risk factor for revision except at 6 months for PROMIS-PF (p = 0.024).Conclusion: LD has been associated with reliable outcomes, but early identification of patients at risk for revision is critical. This study suggests that tools such as PROMIS-PF may serve a role in predicting who is at risk and the 6-month follow-up period may be valuable for counseling patients who are not experiencing improvement.

Lumbar Stenosis with Necrosis of Foot a Diagnostic Approach

Lumbar stenosis is characterised by decrease in spinal canal, neural foramina, lateral nerve .with the narrowing or compression which results in pain and progressive loss. The main objective of the review was to present etiology, pathogenesis and most importantly its clinical presentation along with the necrosis of foot . Study shows that lumbar stenosis can show its improvement by surgical Lumbar decompression and endoscopy.

A PROSPECTIVE STUDY TO EVALUATE THE FUNCTIONAL OUTCOME OF NON- INSTRUMENTED LUMBAR DECOMPRERSSION IN ADULT DEGENERATIVE LUMBAR CANAL STENOSIS [LCS] AND DETERMINE PREDICTIVE FACTORS OF FAVOURABLE OUTCOME

AIM AND OBJECTIVES: A prospective study to evaluate the functional outcome of non- instrumented lumbar decompression in adult degenerative lumbar canal stenosis [LCS] and determine predictive factors of favourable outcome. Study details: Patients attending Orthopedic OPD at BARC Hospital, Mumbai, who were operated for adult degerative LCS from June 2017 to May 2019. CONCLUSION: The VAS and Beaujon score were stasistically significant when compared to preoperative and 3 months post operatively