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Location of Pain May Affect Spinal Surgery Outcome

Decompression surgery for spinal stenosis less effective with greater back pain relative to other pain

FRIDAY, June 5 (HealthDay News) -- Patients undergoing decompression surgery to treat spinal stenosis are likely to have a worse outcome if their preoperative pain in the back is bad relative to pain in the legs or buttocks, according to a study published in the May 15 issue of Spine.

Frank S. Kleinstuck, M.D., of the Schulthess Klinik in Zurich, Switzerland, and colleagues analyzed data from 221 patients who underwent first-time surgery for lumbar degenerative spinal stenosis, and who completed a multidimensional index of outcomes at baseline and 12 months after surgery.

There was a positive correlation between the baseline scores of leg and buttock pain, minus those for lower back pain, and improvement after 12 months, the investigators found. In patients with a good outcome, the mean baseline leg and buttock pain score was 2.3 points higher than the score for lower back pain. In the poor outcome group, the corresponding value was 0.8. The intensity of baseline lower back pain was the most significant predictor of the outcome of surgery after 12 months, the researchers note.

"Overall, greater back pain relative to leg and buttock pain at baseline was associated with a significantly worse outcome after decompression," the authors write. "This finding seems intuitive, but has rarely been quantified in the many predictor studies conducted to date. Consideration of relative lower back pain and leg and buttock pain scores may assist in clinical decision-making and in establishing realistic patient expectations."

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