Evidence & Methods
Delineation of factors associated with a greater or lesser likelihood of success with interventions is important for decision making and for informed consent. This article looks for factors impacting outcomes following surgery for lumbar spinal stenosis.
This prospective study of 94 patients with 2-year follow-up using the Roland–Morris questionnaire (RMDQ) found that higher body mass index and psychiatric factors were associated with poorer outcomes; while patients with more severe preoperative disability did better.
These findings provide some valuable insights, lending support for more casual observations/suspicions and previous study findings. It is of note that this study used only one dimension of outcome, the RMDQ, which focuses upon reported disability in activities of daily living and is not disease-specific. Other dimensions, such as subsequent medication usage, medical care intensity, and satisfaction, were not assessed. Accordingly, these findings may not fully measure the benefit (or lack of benefit) of an intervention for individual patients; patients with severe obesity or depression may show a poor response on RMDQ but may be delighted that their sciatic pain is greatly reduced or that they can now walk around the grocery store.
—The Editors