Omri Maayan, Bo Zhang, Anthony Pajak, Pratyush Shahi, Tejas Subramanian, Troy B Amen, Tomoyuki Asada, Nishtha Singh, Kasra Araghi, Maximillian K Korsun, Sumedha Singh, Olivia C Tuma, Evan D Sheha, James E Dowdell, Sravisht Iyer, Sheeraz A Qureshi, Francis C Lovecchio
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引用次数: 0
Abstract
Study design: Retrospective cohort study.
Objective: To assess the utility of whole-body imaging in diagnosing lower extremity osteoarthritis (LEOA), evaluate the association of LEOA with radiculopathy, and determine the impact of LEOA on postoperative recovery.
Summary of background data: Whole-body imaging offers rapid, low-radiation assessment of both spinal and lower extremity pathology. This modality may be pivotal in helping clinicians better understand how lower extremity pathology influences clinical presentation and recovery among patients with degenerative lumbar conditions.
Methods: Patients with preoperative whole-body imaging who underwent lumbar spine surgery for degenerative conditions between 2017 and 2022 were included. The Kellgren and Lawrence (KL) score was implemented to grade joint osteoarthritis (OA) as mild (KL ≤2) or severe (KL ≥3). Length of stay (LOS) and side of radiculopathy were assessed. The Oswestry disability index (ODI), Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS), visual analog scale (VAS), and Short Form-12 (SF-12) Physical/Mental Component Scales (PCS/MCS) were recorded at preoperative, early-postoperative (2, 6, 12 weeks), and late-postoperative (6, 12, 24 months) timepoints. The association of HOA/KOA with PROMs and minimum clinically important difference (MCID) was evaluated.
Results: Totally, 207 patients were included (HOA: n=130 mild, n=62 severe; KOA: n=141 mild, n=53 severe). Patients with severe OA were significantly older compared with patients with mild OA (P<0.05). OA laterality was not associated with side of radiculopathy. After controlling for age, LOS was ∼50% greater for severe HOA (P=0.031) and severe KOA (P=0.013) compared with mild OA. Severe KOA exhibited worse PROMIS at the early-postoperative timepoint (P=0.013), and worse PROMIS (P=0.049), VAS-back (P=0.009), and SF-12-PCS (P=0.025) at the late-postoperative timepoint. Severe HOA and KOA reduced the likelihood of achieving MCID for SF-12-PCS (OR: 0.44; P=0.049) and PROMIS (OR: 0.37; P=0.027), respectively.
Conclusions: Whole-body imaging may help improve patient-specific counseling on expectations after lumbar spine surgery.
研究设计：回顾性队列研究。目的：评估全身成像在下肢骨关节炎（LEOA）诊断中的应用价值，评估LEOA与神经根病的关系，并确定LEOA对术后恢复的影响。背景资料概述：全身成像提供了快速、低辐射的脊柱和下肢病理评估。这种模式可以帮助临床医生更好地了解下肢病理如何影响腰椎退行性疾病患者的临床表现和康复。方法：纳入2017年至2022年间因退行性疾病行腰椎手术的术前全身成像患者。采用Kellgren and Lawrence （KL）评分将关节骨关节炎（OA）分为轻度（KL≤2）和重度（KL≥3）。评估住院时间（LOS）和神经根病的侧边。在术前、术后早期（2、6、12周）和术后后期（6、12、24个月）记录Oswestry残疾指数（ODI）、患者报告结果测量信息系统身体功能（PROMIS）、视觉模拟量表（VAS）和短表12 （SF-12）身体/心理成分量表（PCS/MCS）。评估HOA/KOA与PROMs和最小临床重要差异（MCID）的关系。结果：共纳入207例患者(HOA: n=130轻度，n=62重度；KOA: n=141轻度，n=53重度)。与轻度OA患者相比，重度OA患者明显变老(结论：全身成像可能有助于改善腰椎手术后患者对期望的特异性咨询。
期刊介绍：
Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure.
Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.
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