Influence of spinopelvic parameters on non-operative treatment of lumbar spinal stenosis.
BACKGROUND
Non-operative treatment is widely accepted for early stages of lumbar spinal stenosis. In general, a trial of conservative treatment is recommended prior to surgery.


OBJECTIVE
The influence of sagittal alignment on treatment outcomes remains unclear.


METHODS
Twenty-five patients were included in this prospective study. All patients received repeated epidural injections and facet joint injections as well as physiotherapy during a one week hospitalization. Patient characteristics, VAS scores, COMI scores, ODI scores and SF-36 were assessed prior to and immediately after treatment as well as after six, twelve, and 26 weeks. Spinopelvic parameter measurements were performed. Outcome parameters were correlated to spinopelvic parameters.


RESULTS
ODI and PCSS scores improved significantly up to three months follow-up. COMI score improved significantly over the entire follow-up. Back pain improvement at six weeks and three months follow-up correlated inversely with pelvic incidence. Sacral slope correlated significantly with ODI improvement immediately after therapy. Low lumbar lordosis also correlated significantly with ODI improvement at three months follow-up.


CONCLUSIONS
Subjects with higher pelvic incidence reported significantly greater back pain improvements at three months follow-up. ODI improvements were higher for patients with high sacral slope immediately after treatment and for patients with a higher lumbar lordosis after three months. No influence of sagittal alignment was observed on leg pain or quality of life.
['Beyer|F|F|', 'Geier|F|F|', 'Bredow|J|J|', 'Oppermann|J|J|', 'Eysel|P|P|', 'Sobottke|R|R|']
D000759:Adjuvants, Anesthesia D000328:Adult D000368:Aged D000369:Aged, 80 and over D000577:Amides D000779:Anesthetics, Local D005260:Female D006801:Humans D007268:Injections, Epidural D008159:Lumbar Vertebrae D008297:Male D008875:Middle Aged D010388:Pelvis D026741:Physical Therapy Modalities D011446:Prospective Studies D011788:Quality of Life D000077212:Ropivacaine D013130:Spinal Stenosis D017409:Sufentanil
spinopelvic parameters non-operative treatment Lumbar spinal stenosis epidural injections sagittal balance