Abstract
Study Design: Prospective cohort study.
Objectives: To evaluate outcomes for back pain following primary single level spinal decompression for nerve root pain.
Subjects: All patients were managed in a single spinal unit with two spinal surgeons following the same management protocol. Any patient undergoing spinal fusion was excluded. Over a five-year period there were 217 patients, with a mean age of 39 years (15 to 78 years). The male to female ratio was 1:1. All had specific single level nerve root pain and definite nerve root compromise confirmed on MRI.
Outcome Measures: All patients were assessed preoperatively and followed at 3, 6, 12 and 24 months using a standard back pain questionnaire including visual analogue scores for leg and back pain, a pain diagram, Oswestry disability index (ODI), Zung depression index and somatisation scores.
Results: We report a statistically significant improvement in back pain post-operatively with 68.6% of patients improving their score (p < 0.001 sign test) with 19.5% reporting complete relief. This improvement was sustained over the follow-up period. Post-operative improvements in back pain correlated well with post surgical reduction in leg pain score, and ODI. Patients with increased back pain scores (> 5) at presentation, were more likely to report an improvement. In this group 80.5% reported a significant reduction in their back pain following surgery. No correlation could be identified between back pain scores and somatisation and Zung depression indices, age, gender or employment status.
Conclusions: These results are contrary to other reported series and suggest the prognosis for back pain following primary single level spinal decompression may be better than anticipated.
These abstracts were prepared by Mr. Brian J C Freeman FRCS (Tr & Orth). Correspondence should be addressed to him at The Centre for Spinal Studies and Surgery, University Hospital, Queens Medical Centre, Nottingham NG7 2UH.
