ArticleThe spine journal : official journal of the North American Spine Society2023
Poor muscle health and low preoperative ODI are independent predictors for slower achievement of MCID after minimally invasive decompression.
Article in The spine journal : official journal of the North American Spine Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 42 citations in OpenAlex.
- PVMQ score: a novel imaging parameter for indicating lumbar degeneration and prognosis in patients with L4/5 degenerative lumbar spondylolisthesis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Identifying preoperative radiographic metrics to guide surgical selection in lumbar spondylolisthesis and stenosis.North American Spine Society journal · 2025Article
- Preoperative Disability Influences Effectiveness of Minimal Clinically Important Difference and Patient Acceptable Symptom State in Predicting Patient Improvement Following Cervical Spine Surgery.Global spine journal · 2025Article
- Outcomes of Minimally Invasive Decompression Alone Versus Fusion for Predominant Back Pain.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2025Article
- Influence of coronal lumbar Cobb angle and surgical level on short-segment lumbar surgery outcomes in degenerative scoliosis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Impact of age on comparative outcomes of decompression alone versus fusion for L4 degenerative spondylolisthesis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
- Artificial neural network analysis of factors affecting functional independence recovery in patients with lumbar stenosis after neurosurgery treatment: An observational cohort study.Journal of orthopaedics · 2024Article
- Magnetically attracting hydrogel reshapes iron metabolism for tissue repair.Science advances · 2024Article
- Article
- Improvement in predominant back pain following minimally invasive decompression for spinal stenosis.Journal of neurosurgery. Spine · 2023Article
- Comparison of the effectiveness of zero-profile device and plate cage construct in the treatment of one-level cervical disc degenerative disease combined with moderate to severe paraspinal muscle degeneration.Frontiers in endocrinology · 2023Article
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17 authors at 1 institution in 1 country.
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Abstract
background contextAlthough some previous studies have analyzed predictors of nonimprovement, most of these have focused on demographic and clinical variables and have not accounted for radiological predictors. In addition, while several studies have examined the degree of improvement after decompression, there is less data on the rate of improvement. PURPOSE: To identify the risk factors and predictors (both radiological and nonradiological) for slower as well as nonachievement of minimal clinically important difference (MCID) after minimally invasive decompression.
designRetrospective cohort. PATIENT SAMPLE: Patients who underwent minimally invasive decompression for degenerative lumbar spine conditions and had a minimum of 1-year follow up were included. Patients with preoperative Oswestry Disability Index (ODI) <20 were excluded. OUTCOME MEASURE: MCID achievement in ODI (cut off 12.8).
methodsPatients were stratified into two groups (achieved MCID, did not achieve MCID) at two timepoints (early ≤3 months, late ≥6 months). Nonradiological (age, gender, BMI, comorbidities, anxiety, depression, number of levels operated, preoperative ODI, preoperative back pain) and radiological (MRI - Schizas grading for stenosis, dural sac cross-sectional area, Pfirrmann grading for disc degeneration, psoas cross-sectional area and Goutallier grading, facet cyst/effusion; X-ray - spondylolisthesis, lumbar lordosis, spinopelvic parameters) variables were assessed with comparative analysis to identify risk factors and with multiple regression models to identify predictors for slower achievement of MCID (MCID not achieved by ≤3 months) and nonachievement of MCID (MCID not achieved at ≥6 months).
resultsA total of 338 patients were included. At ≤3 months, patients who did not achieve MCID had significantly lower preoperative ODI (40.1 vs 48.1, p<0.001) and worse psoas Goutallier grading (p=.048). At ≥6 months, patients who did not achieve MCID had significantly lower preoperative ODI (38 vs 47.5, p<.001), higher age (68 vs 63 years, p=.007), worse average L1-S1 Pfirrmann grading (3.5 vs 3.2, p=.035), and higher rate of pre-existing spondylolisthesis at the operated level (p=.047). When these and other probable risk factors were put into a regression model, low preoperative ODI (p=.002) and poor Goutallier grading (p=.042) at the early timepoint and low preoperative ODI (p<.001) at the late timepoint came out as independent predictors for MCID nonachievement.
conclusionAfter minimally invasive decompression, low preoperative ODI and poor muscle health are risk factors and predictors for slower achievement of MCID. For nonachievement of MCID, low preoperative ODI, higher age, greater disc degeneration, and spondylolisthesis are risk factors and low preoperative ODI is the only independent predictor.
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