title: Influence of spinopelvic parameters on non-operative treatment of lumbar spinal stenosis.
abstract: BACKGROUND
  Non-operative treatment is widely accepted for early stages of lumbar spinal stenosis. In general, a trial of conservative treatment is recommended prior to surgery.
  
  
  OBJECTIVE
  The influence of sagittal alignment on treatment outcomes remains unclear.
  
  
  METHODS
  Twenty-five patients were included in this prospective study. All patients received repeated epidural injections and facet joint injections as well as physiotherapy during a one week hospitalization. Patient characteristics, VAS scores, COMI scores, ODI scores and SF-36 were assessed prior to and immediately after treatment as well as after six, twelve, and 26 weeks. Spinopelvic parameter measurements were performed. Outcome parameters were correlated to spinopelvic parameters.
  
  
  RESULTS
  ODI and PCSS scores improved significantly up to three months follow-up. COMI score improved significantly over the entire follow-up. Back pain improvement at six weeks and three months follow-up correlated inversely with pelvic incidence. Sacral slope correlated significantly with ODI improvement immediately after therapy. Low lumbar lordosis also correlated significantly with ODI improvement at three months follow-up.
  
  
  CONCLUSIONS
  Subjects with higher pelvic incidence reported significantly greater back pain improvements at three months follow-up. ODI improvements were higher for patients with high sacral slope immediately after treatment and for patients with a higher lumbar lordosis after three months. No influence of sagittal alignment was observed on leg pain or quality of life.
authors.affiliation: Department of Orthopedic and Trauma Surgery, Marien Krankenhaus gGmbH, Bergisch Gladbach, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Beyer
authors.affiliation: Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Geier
authors.affiliation: Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Bredow
authors.affiliation: Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Oppermann
authors.affiliation: Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Eysel
authors.affiliation: Department of Orthopedic and Trauma Surgery, Medizinisches Zentrum StädteRegion Aachen GmbH, Würselen, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Sobottke
mesh_terms: D000759:Adjuvants, Anesthesia / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000577:Amides / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007268:Injections, Epidural; D008159:Lumbar Vertebrae / Q000033:anatomy & histology*; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000033:anatomy & histology*; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D011788:Quality of Life; D000077212:Ropivacaine; D013130:Spinal Stenosis / Q000188:drug therapy* / Q000534:rehabilitation*; D017409:Sufentanil / Q000627:therapeutic use
chemical_list: D000759:Adjuvants, Anesthesia; D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D017409:Sufentanil
keywords: Lumbar spinal stenosis; epidural injections; non-operative treatment; sagittal balance; spinopelvic parameters