Affiliations: [a] Department of Orthopedic and Trauma Surgery, Marien Krankenhaus gGmbH, Bergisch Gladbach, Germany | [b] Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany | [c] Department of Orthopedic and Trauma Surgery, Medizinisches Zentrum StädteRegion Aachen GmbH, Würselen, Germany
Correspondence:
[*]
Corresponding author: F. Beyer, Department of Orthopedic and Trauma Surgery, Marien Krankenhaus gGmbH, Dr.-Robert-Koch-Str. 18, 51465 Bergisch Gladbach, Germany. Tel.: +49 2202 938 0; Fax +49 2202 938 2211; E-mail:frank.beyer@gmail.com
Abstract:
BACKGROUND:
Non-operative treatment is widely accepted for early stages of lumbar spinal
stenosis. In general, a trial of conservative treatment is recommended prior
to surgery.
OBJECTIVE:
The influence of sagittal alignment on treatment outcomes remains unclear. METHODS:
Twenty-five patients were included in this prospective study. All patients
received repeated epidural injections and facet joint injections as well as
physiotherapy during a one week hospitalization. Patient characteristics,
VAS scores, COMI scores, ODI scores and SF-36 were assessed prior to and
immediately after treatment as well as after six, twelve, and 26 weeks.
Spinopelvic parameter measurements were performed. Outcome parameters were
correlated to spinopelvic parameters. RESULTS:
ODI and PCSS scores improved significantly up to three months follow-up.
COMI score improved significantly over the entire follow-up. Back pain
improvement at six weeks and three months follow-up correlated inversely
with pelvic incidence. Sacral slope correlated significantly with ODI
improvement immediately after therapy. Low lumbar lordosis also correlated
significantly with ODI improvement at three months follow-up. CONCLUSIONS:
Subjects with higher pelvic incidence reported significantly greater back
pain improvements at three months follow-up. ODI improvements were higher
for patients with high sacral slope immediately after treatment and for
patients with a higher lumbar lordosis after three months. No influence of
sagittal alignment was observed on leg pain or quality of life.
