Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_
Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_ Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_
Poster Topic: Spine Abstract number: 23715 LEG PAIN AND PSYCHOLOGICAL VARIABLES PREDICT OUTRCOME 2-3 YEARS AFTER LUMBAR FUSION SURGERY Allan ABBOTT 1 , Raija TYNI-LENNÉ 2 , Rune HEDLUND 3 1 Karolinska Institute, Stockholm (SWEDEN), 2 Karolinska University Hospital, Stockholm (SWEDEN), 3 Sahlgrenska Akademin, Gothenburg (SWEDEN) Study Design: Prospective cohort study. Objective: To examine predictions of functional disability, back pain intensity and HRQOL 2-3 years after lumbar fusion by regressing nonlinear relations in a multivariate predictive model of pre-surgical variables. Summary of Background Data: Prediction studies testing a thorough range of psychological variables in addition to demographic, work related and clinical variables is lacking in spinal surgery research. Previous studies have not investigated nonlinear relations between response and predictor variables or addressed predictive model validity. Methods: 107 lumbar fusion patients completed questionnaires before and 2-3 years after surgery investigating demographics, work related variables, clinical variables, functional self-efficacy, outcome expectancy, fear of movement/(re)injury, catastrophizing and mental health and pain coping. CATREG regression with optimal scaling transformation, elastic net regularization and bootstrapping were used to investigate predictor variables and address predictive model validity. Results: The most parsimonious subset of pre-surgical predictor variables explained 41.6%, 32.2% and 25.6% of the variance in functional disability, back pain intensity and HRQOL 2-3 years after lumbar fusion. Control over pain significantly predicted functional disability and HRQOL while leg pain intensity and catastrophizing significantly predicted functional disability and back pain. Postoperative rehabilitation focusing on cognition, behaviour and motor control also significantly predicted functional disability while outcome expectations significantly predicted HRQOL. The discriminative ability of the prediction models was of good quality. Conclusions: The study demonstrates the importance of pre-surgical leg pain and psychological factors in the predictions of functional disability, back pain and HRQOL related lumbar fusion outcomes. 396
Poster Topic: Spine Abstract number: 23718 A PROSPECTIVE STUDY ON PROPHYLACTIC HIGH-DOSE METHYLPREDONISOLON THERAPY TO PREVENT C5 PALSY FOLLOWING DECOMPRESSION SURGERY TO PATIENTS WITH CERVICAL OPLL Kazuhiro HASEGAWA, Takao HOMMA, Haruka SHIMODA Niigata Spine Surgery Center, Niigata (JAPAN) INTRODUCTION: C5 palsy is a common complication following cervical surgery especially in ossification of posterior longitudinal ligament (OPLL). We proposed that the etiology is a transient disturbance of the spinal cord (SPINE 2007). Thus, we pursued countermeasures to prevent the complication. The purpose of this prospective study was to test the hypothesis that methylprednisolone administration in a dose advocated by NASCIS-II (MPTx) is effective to prevent C5 palsy. METHODS: Thirty-eight patients with myelopathy due to cervical OPLL (mean age=58.3 y, M/F=25/13) were treated by laminoplasty with MPTx (group MPTx). An age- and sex- matched patients who underwent laminoplasty for cervical OPLL without MPTx (mean age=60.7 y, M/F=35/23, group non-MPTx) were used as a control group. Frequency of C5 palsy was compared, and a risk factor analysis was performed on sex, age, procedure, area of decompression, MPTx, and preoperative JOA score. RESULTS: C5 palsy occurred 7 patients (12.1%) in group non-MPTx, whereas none in group MPTx (p
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Poster<br />
Topic: Spine<br />
Abstract number: 23718<br />
A PROSPECTIVE STUDY ON PROPHYLACTIC HIGH-DOSE<br />
METHYLPREDONISOLON THERAPY TO PREVENT C5 PALSY FOLLOWING<br />
DECOMPRESSION SURGERY TO PATIENTS WITH CERVICAL OPLL<br />
Kazuhiro HASEGAWA, Takao HOMMA, Haruka SHIMODA<br />
Niigata Spine Surgery Center, Niigata (JAPAN)<br />
INTRODUCTION: C5 palsy is a common complication following cervical surgery<br />
especially in ossification of posterior longitudinal ligament (OPLL). We proposed that<br />
the etiology is a transient disturbance of the spinal cord (SPINE 2007). Thus, we<br />
pursued countermeasures to prevent the complication. The purpose of this<br />
prospective study was to test the hypothesis that methylprednisolone administration<br />
in a dose advocated by NASCIS-II (MPTx) is effective to prevent C5 palsy.<br />
METHODS: Thirty-eight patients with myelopathy due to cervical OPLL (mean<br />
age=58.3 y, M/F=25/13) were treated by laminoplasty with MPTx (group MPTx). An<br />
age- and sex- matched patients who underwent laminoplasty for cervical OPLL<br />
without MPTx (mean age=60.7 y, M/F=35/23, group non-MPTx) were used as a<br />
control group. Frequency of C5 palsy was compared, and a risk factor analysis was<br />
performed on sex, age, procedure, area of decompression, MPTx, and preoperative<br />
JOA score. RESULTS: C5 palsy occurred 7 patients (12.1%) in group non-MPTx,<br />
whereas none in group MPTx (p
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