Comparative Effectiveness of Microdecompression and Laminectomy for Central Lumbar Spinal Stenosis
Comparative Effectiveness of Microdecompression and Laminectomy for Central Lumbar Spinal Stenosis - An Observational Study
Introduction: This observational study is designed to test the equivalence between the clinical effectiveness of microdecompression and laminectomy in the surgical treatment of central lumbar spinal stenosis. Lumbar spinal stenosis is the most frequent indication for spinal surgery in the elderly, and as the oldest segment of the population continues to grow its prevalence is likely to increase. However, data on surgical outcomes are limited. Open or wide decompressive laminectomy, often combined with medial facetectomy and foraminotomy, was formerly the standard treatment. In recent years a growing tendency towards less invasive decompressive procedures has emerged. Many spine surgeons today perform microdecompression for central lumbar spinal stenosis.
Prospectively registered treatment and outcome data are obtained from the Norwegian Registry for Spine Surgery (NORspine).
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Locations
-
-
-
Trondheim, Norway
- St.Olavs Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Diagnosis of central lumbar spinal stenosis
- Operation in ≤2 lumbar levels with either open decompressive laminectomy, bilateral microdecompression or unilateral microdecompression for bilateral decompression in the time period between October 2006 and December 2011
- Included in the NORspine registry
Exclusion Criteria:
- History of lumbar fusion
- Previous surgery in the lumbar spine
- Discectomy as part of the decompression
- Associated pathological entities such as disc herniation, spondylolisthesis or scoliosis.
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
microdecompression
surgical microdecompression using a bilateral or unilateral approach depending on the surgeon's preference and the individual patient's anatomy and symptoms.
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a minimal invasive surgical technique
|
|
laminectomy
the spinous process and the laminae of the involved level(s) as well as the medial aspects of the facet joints are resected
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The traditional open surgical technique: decompression with removal of the spinous process, lamina and often the medial facets
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
change in Oswestry Disability Index
Time Frame: between baseline and 12-months follow-up
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collected through the Norwegian Registry for Spine Surgery (NORspine)
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between baseline and 12-months follow-up
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
changes in health-related quality of life
Time Frame: between baseline and 12-months follow-up
|
measured by Euro-Qol-5D, collected through the Norwegian Registry for Spine Surgery (NORspine)
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between baseline and 12-months follow-up
|
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patient reported post-operative complications
Time Frame: 3 months
|
wound infection, urinary tract infection, pneumonia, pulmonary embolism, and deep venous thrombosis
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3 months
|
|
surgeon reported complication
Time Frame: reported at discharge (expected average hospital stay of 3 days)
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intraoperative hemorrhage requiring blood replacement, unintentional durotomy, cardiovascular complications, respiratory complications, anaphylactic reactions, and wrong level surgery
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reported at discharge (expected average hospital stay of 3 days)
|
|
Length of hospital stay
Time Frame: reported at discharge (expected average hospital stay of 3 days)
|
Length of hospital stay before discharge
|
reported at discharge (expected average hospital stay of 3 days)
|
|
Length of surgery
Time Frame: reported at discharge (expected average hospital stay of 3 days)
|
Length of surgery
|
reported at discharge (expected average hospital stay of 3 days)
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Sasha Gulati, MD, PhD, St. Olavs Hospital
Publications and helpful links
General Publications
- Nerland US, Jakola AS, Solheim O, Weber C, Rao V, Lonne G, Solberg TK, Salvesen O, Carlsen SM, Nygaard OP, Gulati S. Minimally invasive decompression versus open laminectomy for central stenosis of the lumbar spine: pragmatic comparative effectiveness study. BMJ. 2015 Apr 1;350:h1603. doi: 10.1136/bmj.h1603.
- Nerland US, Jakola AS, Solheim O, Weber C, Rao V, Lonne G, Solberg TK, Salvesen O, Carlsen SM, Nygaard OP, Gulati S. Comparative effectiveness of microdecompression and laminectomy for central lumbar spinal stenosis: study protocol for an observational study. BMJ Open. 2014 Mar 20;4(3):e004651. doi: 10.1136/bmjopen-2013-004651.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2013/643
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