Clinical and radiographic factors associated with residual low back pain after single-level decompression for lumbar spinal stenosis: a multicenter retrospective cohort study.

IF 5.1 1区医学 Q1 CLINICAL NEUROLOGY

Spine Journal Pub Date : 2026-10-20 DOI:10.1016/j.spinee.2026.10.014

Yudai Kumanomido, Koji Nakajima, Yutaro Oba, Naoto Komatsu, Hiroyasu Kodama, Michita Noma, Hiroyuki Nakarai, Ryuji Sakamoto, Junya Miyahara, Hideki Nakamoto, So Kato, Yuki Taniguchi, Naohiro Kawamura, Akiro Higashikawa, Yujiro Takeshita, Masayoshi Fukushima, Nobuhiro Hara, Sakae Tanaka, Yasushi Oshima

{"title":"Clinical and radiographic factors associated with residual low back pain after single-level decompression for lumbar spinal stenosis: a multicenter retrospective cohort study.","authors":"Yudai Kumanomido, Koji Nakajima, Yutaro Oba, Naoto Komatsu, Hiroyasu Kodama, Michita Noma, Hiroyuki Nakarai, Ryuji Sakamoto, Junya Miyahara, Hideki Nakamoto, So Kato, Yuki Taniguchi, Naohiro Kawamura, Akiro Higashikawa, Yujiro Takeshita, Masayoshi Fukushima, Nobuhiro Hara, Sakae Tanaka, Yasushi Oshima","doi":"10.1016/j.spinee.2026.10.014","DOIUrl":null,"url":null,"abstract":"Background context: Residual low back pain (LBP) after decompression for lumbar spinal stenosis (LSS) varies considerably and is likely multifactorial. It remains unclear how residual LBP differs by preoperative severity and which factors are independently associated with it.Purpose: To examine how postoperative LBP improves across preoperative severity groups and to identify clinical and radiographic factors independently associated with residual LBP.Study design/setting: Multicenter retrospective cohort study.Patient sample: A total of 450 patients undergoing primary single-level posterior decompression for LSS at six institutions (2017-2023).Outcome measures: The primary outcome was the 1-year postoperative numerical rating scale (NRS) score for LBP. Secondary outcomes were buttock and leg pain NRS, Oswestry Disability Index, EuroQol 5-Dimension, and postoperative satisfaction.Methods: Patients were stratified into three predefined preoperative LBP severity groups (Mild 0-3, Moderate 4-7, Severe 8-10). Inverse probability weighting (IPW) was applied for three-group comparisons. Unweighted multivariable linear regression for postoperative LBP NRS included preoperative LBP NRS together with patient, surgical, and radiographic factors as covariates. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors report no study-specific conflicts of interest.Results: The IPW-adjusted Severe group showed the largest LBP NRS improvement (4.5 points) but the highest residual LBP NRS (4.1). Dissatisfaction did not differ across groups (p=.244). Factors independently associated with residual LBP were preoperative LBP NRS (B=0.381, p<.001), pelvic incidence-lumbar lordosis (PI-LL) >20° (B=0.681, p=.024), and American Society of Anesthesiologists Physical Status (ASA-PS) ≥3 (B=1.298, p=.017).Conclusions: Greater preoperative LBP severity was associated with both larger improvement and higher residual LBP. Preoperative LBP severity, PI-LL >20°, and ASA-PS ≥3 were independent factors for residual LBP.","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":5.1000,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.spinee.2026.10.014","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background context: Residual low back pain (LBP) after decompression for lumbar spinal stenosis (LSS) varies considerably and is likely multifactorial. It remains unclear how residual LBP differs by preoperative severity and which factors are independently associated with it.

Purpose: To examine how postoperative LBP improves across preoperative severity groups and to identify clinical and radiographic factors independently associated with residual LBP.

Study design/setting: Multicenter retrospective cohort study.

Patient sample: A total of 450 patients undergoing primary single-level posterior decompression for LSS at six institutions (2017-2023).

Outcome measures: The primary outcome was the 1-year postoperative numerical rating scale (NRS) score for LBP. Secondary outcomes were buttock and leg pain NRS, Oswestry Disability Index, EuroQol 5-Dimension, and postoperative satisfaction.

Methods: Patients were stratified into three predefined preoperative LBP severity groups (Mild 0-3, Moderate 4-7, Severe 8-10). Inverse probability weighting (IPW) was applied for three-group comparisons. Unweighted multivariable linear regression for postoperative LBP NRS included preoperative LBP NRS together with patient, surgical, and radiographic factors as covariates. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors report no study-specific conflicts of interest.

Results: The IPW-adjusted Severe group showed the largest LBP NRS improvement (4.5 points) but the highest residual LBP NRS (4.1). Dissatisfaction did not differ across groups (p=.244). Factors independently associated with residual LBP were preoperative LBP NRS (B=0.381, p<.001), pelvic incidence-lumbar lordosis (PI-LL) >20° (B=0.681, p=.024), and American Society of Anesthesiologists Physical Status (ASA-PS) ≥3 (B=1.298, p=.017).

Conclusions: Greater preoperative LBP severity was associated with both larger improvement and higher residual LBP. Preoperative LBP severity, PI-LL >20°, and ASA-PS ≥3 were independent factors for residual LBP.

查看原文本刊更多论文

临床和影像学因素与腰椎管狭窄单节段减压术后残留腰痛相关：一项多中心回顾性队列研究

背景背景：腰椎管狭窄症（LSS）减压后的残余腰痛（LBP）差异很大，可能是多因素的。目前尚不清楚术前严重程度的差异以及哪些因素与之独立相关。目的：研究术前严重程度组术后腰痛的改善情况，并确定与腰痛残留独立相关的临床和影像学因素。研究设计/设置：多中心回顾性队列研究。患者样本：共有450名患者在6家机构（2017-2023）接受LSS的初级单节段后路减压。结局指标：主要结局为术后1年LBP数值评定量表（NRS）评分。次要结局为臀腿疼痛NRS、Oswestry残疾指数、EuroQol 5-Dimension和术后满意度。方法：术前将患者分为轻度0-3、中度4-7、重度8-10三个预先确定的腰痛严重程度组。三组比较采用逆概率加权（IPW）。术后LBP NRS的非加权多变量线性回归包括术前LBP NRS以及患者、手术和放射学因素作为协变量。这项研究没有从公共、商业或非营利部门的资助机构获得任何具体的资助。作者报告没有特定研究的利益冲突。结果：经ipw调整后的重度组LBP NRS改善最大（4.5分），但LBP残余NRS最高（4.1分）。不满意程度在各组间无差异（p= 0.244）。与LBP残留独立相关的因素为术前LBP NRS (B=0.381, p20°（B=0.681, p= 0.024）和美国麻醉医师协会身体状态(ASA-PS)≥3 （B=1.298, p= 0.017）。结论：术前腰痛严重程度越大，改善越大，残余腰痛也越大。术前腰痛严重程度、PI-LL > - 20°、ASA-PS≥3是腰痛残留的独立因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Spine Journal 医学-临床神经学

CiteScore

8.20

自引率

6.70%

发文量

680

审稿时长

13.1 weeks

期刊介绍： The Spine Journal, the official journal of the North American Spine Society, is an international and multidisciplinary journal that publishes original, peer-reviewed articles on research and treatment related to the spine and spine care, including basic science and clinical investigations. It is a condition of publication that manuscripts submitted to The Spine Journal have not been published, and will not be simultaneously submitted or published elsewhere. The Spine Journal also publishes major reviews of specific topics by acknowledged authorities, technical notes, teaching editorials, and other special features, Letters to the Editor-in-Chief are encouraged.