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Pre-operative prognostic factors for walking capacity after surgery for lumbar spinal stenosis: a systematic review.

Age and ageing
January 1, 1970
Suzanne McIlroy et al. (8 authors)
Journal ArticleResearch Support, Non-U.S. Gov'tSystematic ReviewHuman Study
Study Details

Study Goal

The researchers aimed to identify pre-operative prognostic factors (both mutable and immutable) associated with post-operative walking capacity in adults with lumbar spinal stenosis (LSS).

Results Summary

The study found moderate-quality evidence that greater pre-operative walking capacity is positively associated with post-operative walking capacity, while spondylolisthesis and severity of stenosis were not associated. Most other factors had low or very low evidence levels.

Population

Adults receiving surgery for lumbar spinal stenosis (LSS).

Effective Dosage

Not available

Duration

Not available

Interactions

None mentioned

Extracted Claims (4)
InterventionDirectionEndpointPopulationDosageImpactClaim #
surgery for LSS
decrease
walking
older people
40%
reduces
#1
pre-operative walking capacity
increase
post-operative walking capacity
adults with LSS
-
was positively associated with
#2
the presence of spondylolisthesis
no change
post-operative walking capacity
adults with LSS
-
was not associated with
#3
the severity of stenosis
no change
post-operative walking capacity
adults with LSS
-
was not associated with
#4
Abstract

BACKGROUND: Lumbar spinal stenosis (LSS) reduces walking and quality of life. It is the main indication for spinal surgery in older people yet 40% report walking disability post-operatively. Identifying the prognostic factors of post-operative walking capacity could aid clinical decision-making, guide rehabilitation and optimise health outcomes. OBJECTIVE: To synthesise the evidence for pre-operative mutable and immutable prognostic factors for post-operative walking in adults with LSS. DESIGN: Systematic review with narrative synthesis. METHODS: Electronic databases (CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, OpenGrey) were searched for observational studies, evaluating factors associated with walking after surgery in adults receiving surgery for LSS from database inception to January 2020. Two reviewers independently evaluated studies for eligibility, extracted data and assessed risk of bias (Quality in Prognosis Studies). The Grading of Recommendations Assessment, Development and Evaluation method was used to determine level of evidence for each factor. RESULTS: 5526 studies were screened for eligibility. Thirty-four studies (20 cohorts, 9,973 participants, 26 high, 2 moderate, 6 low risk of bias) were included. Forty variables (12 mutable) were identified. There was moderate quality of evidence that pre-operative walking capacity was positively associated with post-operative walking capacity. The presence of spondylolisthesis and the severity of stenosis were not associated with post-operative walking capacity. All other factors investigated had low/very low level of evidence. CONCLUSION: Greater pre-operative walking is associated with greater post-operative walking capacity but not spondylolisthesis or severity of stenosis. Few studies have investigated mutable prognostic factors that could be potentially targeted to optimise surgical outcomes.

Medical Subject Headings (MeSH)
AgedHumansLumbar VertebraePrognosisQuality of LifeSpinal StenosisWalking
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality85/10
Citation Metrics
Total Citations6
Citations/Year1.5
Relative Citation Ratio0.87
NIH Percentile45.2%
Research Impact Scores
APT Score0.50
Weight Score1.66
Normalized Score0.67
Related Supplements
Pre-operative prognostic factors for walking capacity after ... | Panacea Index