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This is a discussion on Outcome After Surgical Treatment for Lumbar Spinal Stenosis: The Lumbar Extension Test Is Not a Predictive Factor within the Education, Research and Spine Publications forums, part of the General Spine Discussion Forums category; Outcome After Surgical Treatment for Lumbar Spinal Stenosis: The Lumbar Extension Test Is Not a Predictive Factor Spine . Volume ...
Outcome After Surgical Treatment for Lumbar Spinal Stenosis: The Lumbar Extension Test Is Not a Predictive Factor Outcome After Surgical Treatment for Lumbar Spinal Stenosis: The Lumbar Extension Test Is Not a Predictive Factor
Spine. Volume 34(25), 1 December 2009, pp E930-E935
Westergaard, Lars MD; Hauerberg, John MD; Springborg, Jacob B. MD, PhD. From the Neuroscience Center, University Clinic of Neurosurgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark. Copyright: © 2009 Lippincott Williams & Wilkins, Inc.
Study Design. A prospective clinical study.
Objectives. To investigate the predictive value of the lumbar extension test for outcome after surgical treatment of lumbar spinal stenosis (LSS).
Summary of Background Data. Studies have indicated that aggravation of the symptoms from LSS by extension of the lumbar spine has predictive value for the outcome after decompression. The aim of this study was to investigate this theory in a larger group of patients.
Methods. One hundred forty-six consecutive patients surgically treated for LSS were included in the study. The clinical condition was recorded before surgery and at 3, 6, 12, and 24 months after surgery using 3 different scoring systems: Swiss Spinal Stenosis Questionnaire, Neurogenic Claudication Outcome Score, and Oswestry Disability Index. The group of patients with preoperative aggravation of the symptoms by the lumbar extension test, (positive extension test), was compared with the group of patients without aggravation by the test, (negative extension test).
Results. Before surgery, patients with a positive extension test scored significantly worse on all disability scoring systems than patients with a negative test. However, the extension test itself had no prognostic value for the overall outcome after lumbar decompression. Using regression models with the 2-year Oswestry Disability Index as dependent variable, only before surgery self-reported health and age were found to have prognostic significance.
Conclusion. The lumbar extension test has no predictive value for the outcome after surgical treatment of LSS.
lumbar extension test, lumbar laminectomy, lumbar spinal stenosis, predictive factor, prospective study
Justin Averna
Founder & President, Spine Patient Society™
www.SpinePatientSociety.org
A 501(c)(3) Tax-Exempt Nonprofit & Charitable Organization
I'm here to help.
- 1994: Football Injury, Severe Hyperextension
- 1997: Snow Skiing Injury
- 3/7/1997: Laminotomy L4/L5
- 1999 & 2003: Motor Vehicle Accidents (not at fault both times) --> Grade V Annular Tears L4/L5 & L5/L6
- 11/15/2003: 2-Level ProDisc® L4/L5 & L5/L6*, *lumbosacral transitional vertebra --> Dr. Rudolf Bertagnoli
- 4/2008: 4.5 years pain-free before "new" leg pain
- 5/14/2009: Dynamic Stabilization System L4/L5, Dr. Rudolf Bertagnoli
Questions? Suggestions? Need help with registering, creating a signature, etc.?
justin (at) spinepatientsociety.org
Disclosure: I have no financial relationships with any surgeons, spine clinics, device manufacturers, pharmaceutical companies, hospitals, etc. -- the SPS Board of Directors serve without compensation.
What is a lumbar extension test?
• January 2000 MVA passenger, used jaws of life to retrieve me, neck injury and months of PT
• June 2001 Bicycle accident, 2 compression fractures at T12/L1, Vertebroplasty Sept. 2001
• April 2006 right hip, labral tear and repair
• April 2007 3 level ProDisc @ L3/4, L4/5 & L5/6✷ ✷Lumbosacral transitional vertebra; Dr. Rudolph Bertagnoli
• July 2, 2008 ALIF & Laminectomy @ L6/S1
• July 30, 2008 re-opened 28 days later to remove bone cement that had leaked onto S1 nerve root
• August 2008 Pulmonary embolism, double pneumonia, collapsed left lung, re-hospitalized 1 week
• March 10, 2009 Right SI Joint Fusion
• April 27, 2010 2nd right hip arthroscopy to remove adhesions and release psoas muscle
• September 30, 2010 lumbar facet rhizotomy
• December 9, 2010 12 bilateral lumbar trigger point and steroid injections
• December 23, 2010 12 more bilateral trigger point injections w/o steroid
• February 15, 2011 ESI bilaterally in lower lumbar...relief only for few days. Considering 1 more.
Did Spinal Cord Stimulator trial from 5/11/11-5/17/11 with excellent results; Spinal Cord Stimulator surgery is Monday,
July 18, 2011
Hi CL,Originally Posted by Cindylou
What is a lumbar extension test?
The lumbar extension test is simply bending backwards while standing (with one's hips in a fixed position).
Justin Averna
Founder & President, Spine Patient Society™
www.SpinePatientSociety.org
A 501(c)(3) Tax-Exempt Nonprofit & Charitable Organization
I'm here to help.
- 1994: Football Injury, Severe Hyperextension
- 1997: Snow Skiing Injury
- 3/7/1997: Laminotomy L4/L5
- 1999 & 2003: Motor Vehicle Accidents (not at fault both times) --> Grade V Annular Tears L4/L5 & L5/L6
- 11/15/2003: 2-Level ProDisc® L4/L5 & L5/L6*, *lumbosacral transitional vertebra --> Dr. Rudolf Bertagnoli
- 4/2008: 4.5 years pain-free before "new" leg pain
- 5/14/2009: Dynamic Stabilization System L4/L5, Dr. Rudolf Bertagnoli
Questions? Suggestions? Need help with registering, creating a signature, etc.?
justin (at) spinepatientsociety.org
Disclosure: I have no financial relationships with any surgeons, spine clinics, device manufacturers, pharmaceutical companies, hospitals, etc. -- the SPS Board of Directors serve without compensation.
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