Comparing Pain Intensity after Surgery for Patients with Spinal Stenosis using with and without Instrumentation
More details
Hide details
Medicine Faculty, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IRAN
Education Center, Aria Hospital, Ahvaz, IRAN
Department of Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IRAN
Department of Medical Sciences, University of Medical Sciences, Boshehr, IRAN
Online publish date: 2018-02-03
Publish date: 2018-02-03
Eurasian J Anal Chem 2018;13(3):em18
Spinal stenosis has been diagnosed as a factor leading to low back pain; medicinal and surgical actions play a vital role in reducing spinal stenosis and low back pain. The purpose of this study was to compare pain intensity after surgery for patients with spinal stenosis with and without instrumentation. This was a descriptive-analytical study. Considering the sample size formula, 144 patients who had spinal stenosis surgery through target-based method were entered in this research. Patients with spinal stenosis divided to two groups of group 1 consisting of 72 patients who had non-instrumented spinal stenosis surgery (Laminectomy) and group 2 consisting of 72 patients who had instrumented spinal stenosis surgery (Pedicular Screw Fixation). Demographic data questionnaire of Numeric Pain Rating Scale was used as data collection tool in this study. In this research, patient expressed and recorded his/her pain intensity in checklist using vas scale under the supervision of researcher. Data were analyzed using statistical tests of paired t test, independent t test, and Chi-square through SPSS22 Software. Findings indicated no significant statistical difference (P>0.05) between studied group in terms of age, sex, education, marital status, and job. In case of pain intensity considering the value of p=0.0001, mean difference in pain intensity of the group with instrumentation was significant before and after intervention and considering the obtained p=1.000, this mean difference was not significant before and after intervention in the group without instrumentation. Moreover, mean of changes in pain intensity scores of two groups indicted no significant difference (P<0.0001). This means that pain intensity among group members with instrument was lower than group without instrument (P<0.098). Pedicular Screw Fixation can be named as one of effective methods in treating lumbar disc that not only reduces pain after surgery but also enables patient to do daily activities.
1. Rutten GM, Degen S, Hendriks EJ, Braspenning JC, Harting J, Oostendorp RA. Adherence to clinical practice guidelines for low back pain in physical therapy: do patients benefit? Physical therapy. 2016;90(8):1111-22.
2. Wertli MM, Rasmussen-Barr E, Weiser S, Bachmann LM, Brunner F. The role of fear avoidance beliefs as a prognostic factor for outcome in patients with nonspecific low back pain: a systematic review. The spine journal. 2014;14(5):816-36.
3. Kamper SJ, Apeldoorn AT, Chiarotto A, Smeets RJ, Ostelo RW, Guzman J, van Tulder MW. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. A dissetation Published by John Wiley & Sons, Ltd. 2015. https://doi.org/10.1002/14651858.CD000963.pub3.
4. Cramer H, Lauche R, Haller H, Dobos G. A systematic review and meta-analysis of yoga for low back pain. The Clinical journal of pain. 2013;29(5):450-60.
5. Oichi T, Oshima Y, Okazaki R, Azuma S. Preexisting severe cervical spinal cord compression is a significant risk factor for severe paralysis development in patients with traumatic cervical spinal cord injury without bone injury: a retrospective cohort study. European Spine Journal. 2016;25(1):96-102.
6. Munting E, Röder C, Sobottke R, Dietrich D, Aghayev E. Patient outcomes after laminotomy, hemilaminectomy, laminectomy and laminectomy with instrumented fusion for spinal canal stenosis: a propensity score-based study from the Spine Tango registry. European spine journal. 2015;24(2):358-68.
7. Chang V, Ellingson BM, Salamon N, Holly LT. The risk of acute spinal cord injury after minor trauma in patients with preexisting cervical stenosis. Neurosurgery. 2015;77(4):561-5.
8. Fritsch Carolina G. The clinical course of pain and disability following surgery for spinal stenosis: a systematic review and meta-analysis of cohort studies. European Spine Journal. 2017;26(2):324-35.‏.
9. Friedly Janna L. Randomized trial of epidural glucocorticoid injections for spinal stenosis. New England Journal of Medicine. 2014;371(1):11-21.‏.
10. Urbana-CHampaign IL. Manhikanti, Laxmaiah. Cost utility analysis of caudal epidural injections in the treatment of lumbar disc herniation, axial or discogenic low back pain, central spinal stenosis, and post lumbar surgery syndrome. Pain Physician. 2013;16(1):129-43.‏.
11. Piazza M, Schuster J. Timing of surgery after spinal cord injury. Neurosurgery Clinics, 28(1), 31-9.
12. Sobottke R, Herren C, Siewe J, Mannion AF, Röder C, Aghayev E. (2017). Predictors of improvement in quality of life and pain relief in lumbar spinal stenosis relative to patient age: a study based on the Spine Tango registry. European Spine Journal. 2017;26(2):462-72.
13. Ramos AD, Rolston JD, Gauger GE, Larson PS. Spinal Subdural Abscess Following Laminectomy for Symptomatic Stenosis: A Report of 2 Cases and Review of the Literature. The American journal of case reports. 2016;1(7):476-85.
14. Bartels RH, van Tulder MW, Moojen WA, Arts MP, Peul WC. Laminoplasty and laminectomy for cervical sponydylotic myelopathy: a systematic review. European Spine Journal. 2015;24(2):160-7.
15. Jeon CH, Lee HD, Lee YS, Seo HS, Chung NS. Change in sagittal profiles after decompressive laminectomy in patients with lumbar spinal canal stenosis: a 2-year preliminary report. Spine (Phila Pa 1976). 2015;40(5):279-85.
16. Guha D, Heary RF, Shamji MF. Iatrogenic spondylolisthesis following laminectomy for degenerative lumbar stenosis: systematic review and current concepts. Neurosurgical focus. 2015;39(4):1-8.
17. Mobbs RJ, Li J, Sivabalan P, Raley D, Rao PJ. Outcomes after decompressive laminectomy for lumbar spinal stenosis: comparison between minimally invasive unilateral laminectomy for bilateral decompression and open laminectomy. Journal of Neurosurgery: Spine. 2014;21(2):179-86.
18. Paudel B, Chhabra HS, Pradhan RL, Arora M. Outcome of Surgical Decompression in Simple Degenerative Lumbar Canal Stenosis. Nepal Orthopaedic Association Journal. 2014;3(2):2-9.
19. Atlasi M, Morhdi V. Evaluation of quality of life in patients with chronic low back pain referring to physiotherapy centers in Ardebil, Journal of Medical Sciences, 47(2). 2014;209-15. [In Persian].
20. Catez A, Raszewska PV. Patient Satisfaction after Spleur Surgery. Neurosurgical focus. 2015;19(5):10-20.
21. Mpofu E, Craig A, Millington M, Murphy G, Dorstyn D. Return to work practices and research with spinal cord injury: An Australian perspective. The Australian Journal of Rehabilitation Counselling. 2015;21(1):65-76.
22. Oosterhuis T, Costa LO, Maher CG, De Vet HC. Van Tulder MW, Ostelo RW. Rehabilitation after lumbar disc surgery—an updated cochrane review. Physiotherapy. 2015;101:1158-9.
23. Hu W, Zhao J, Gong C, Zou M, Yuan JH, Liu XY. A comparation of efficacy between unilateral laminectomy approach bilateral decompression and traditional total laminectomy decompression in the treatment of lumbar spinal stenosis. Zhonghua yi xue za zhi. 2016;96(21):1673-6.
24. Jayarao A, Lee CH, Wei L, Lui TN, Lin TJ. Comparison of percutaneous endoscopic lumbar discectomy and open lumbar surgery for adjacent segment degeneration and recurrent disc herniation. Neurology research international. 2010;22(4):339-52.
25. Inanır A, Sogut E, Ayan M, Inanır S. Evaluation of pain intensity and oxidative stress levels in patients with inflammatory and non-inflammatory back pain. European Journal of General Medicine. 2013;10(4):185–90.