Health-related quality of life after surgical treatment for lumbar stenosis.

Abstract

We performed a retrospective study using the Short Form-36 Health Survey questionnaire (SF-36), clinical examination, and neuroradiologic and neurophysiologic measurements. To evaluate patient outcomes, health-related quality of life (HRQoL), and clinical and neurophysiologic picture in a follow-up study of surgery for lumbar stenosis (LS). In LS patients, clinical, neuroradiologic, and neurophysiologic findings were not related with validated measurement of the outcomes that are more relevant to patients such as functional status and symptoms. Thirty patients surgically treated for LS were recontacted and evaluated by means of self-administered questionnaires (SF-36), clinical examination, and neuroradiologic and neurophysiologic measurements. Preoperative and follow-up clinical and neurophysiologic findings were registered. Relations between patient-oriented data and validated conventional clinical, neuroradiologic, and neurophysiologic measurements were evaluated. A comparison between preoperative and postoperative clinical picture shows an improvement of most parameters tested. A comparison between preoperative and postoperative neurophysiologic picture shows a worsening of most parameters tested. A comparison between the current sample and Italian normative data for the SF-36 shows a worsening of physical aspects of health-related quality of life; conversely, there is an improvement of some mental domains. Follow-up evaluation of surgical treatment for LS showed a mild impairment of physical aspects of HRQoL, as measured by patient-oriented evaluation. Clinical examination findings showed significant improvement. Conversely, neurophysiologic follow-up showed a discordant outcome. We think that, to better assess the surgical indication, further study should be performed focused on natural history and the association between neurophysiologic evolution and patient outcome, etc.