LumbSten: the lumbar spinal stenosis outcome study.
BACKGROUND
Lumbar spinal stenosis is the most frequent reason for spinal surgery in elderly people. For patients with moderate or severe symptoms different conservative and surgical treatment modalities are recommended, but knowledge about the effectiveness, in particular of the conservative treatments, is scarce. There is some evidence that surgery improves outcome in about two thirds of the patients. The aims of this study are to derive and validate a prognostic prediction aid to estimate the probability of clinically relevant improvement after surgery and to gain more knowledge about the future course of patients treated by conservative treatment modalities.


METHODS
This is a prospective, multi-centre cohort study within four hospitals of Zurich, Switzerland. We will enroll patients with neurogenic claudication and lumbar spinal stenosis verified by Computer Tomography or Magnetic Resonance Imaging. Participating in the study will have no influence on treatment modality. Clinical data, including relevant prognostic data, will be collected at baseline and the Swiss Spinal Stenosis Questionnaire will be used to quantify severity of symptoms, physical function characteristics, and patient's satisfaction after treatment (primary outcome). Data on outcome will be collected 6 weeks, and 6, 12, 24 and 36 months after inclusion in the study. Applying multivariable statistical methods, a prediction rule to estimate the course after surgery will be derived.


CONCLUSIONS
The ultimate goal of the study is to facilitate optimal, knowledge based and individualized treatment recommendations for patients with symptomatic lumbar spinal stenosis.
Horten Centre for patient oriented research and knowledge transfer, University of Zurich, University Hospital, 8091 Zurich, Switzerland. johann.steurer@usz.ch
Johann
J
Steurer
Alexander
A
Nydegger
Ulrike
U
Held
Florian
F
Brunner
Jürg
J
Hodler
François
F
Porchet
Kan
K
Min
Anne F
AF
Mannion
Beat
B
Michel
D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods; D017063:Outcome Assessment, Health Care / Q000379:methods*; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D013130:Spinal Stenosis / Q000175:diagnosis / Q000534:rehabilitation* / Q000601:surgery*; D055009:Spondylosis / Q000175:diagnosis / Q000534:rehabilitation* / Q000601:surgery*