title: Predictive Factors for Subjective Improvement in Lumbar Spinal Stenosis Patients with Nonsurgical Treatment: A 3-Year Prospective Cohort Study.
abstract: OBJECTIVE
  To assess the predictive factors for subjective improvement with nonsurgical treatment in consecutive patients with lumbar spinal stenosis (LSS).
  
  
  METHODS
  Patients with LSS were enrolled from 17 medical centres in Japan. We followed up 274 patients (151 men; mean age, 71 ± 7.4 years) for 3 years. A multivariable logistic regression model was used to assess the predictive factors for subjective symptom improvement with nonsurgical treatment.
  
  
  RESULTS
  In 30% of patients, conservative treatment led to a subjective improvement in the symptoms; in 70% of patients, the symptoms remained unchanged, worsened, or required surgical treatment. The multivariable analysis of predictive factors for subjective improvement with nonsurgical treatment showed that the absence of cauda equina symptoms (only radicular symptoms) had an odds ratio (OR) of 3.31 (95% confidence interval [CI]: 1.50-7.31); absence of degenerative spondylolisthesis/scoliosis had an OR of 2.53 (95% CI: 1.13-5.65); <1-year duration of illness had an OR of 3.81 (95% CI: 1.46-9.98); and hypertension had an OR of 2.09 (95% CI: 0.92-4.78).
  
  
  CONCLUSIONS
  The predictive factors for subjective symptom improvement with nonsurgical treatment in LSS patients were the presence of only radicular symptoms, absence of degenerative spondylolisthesis/scoliosis, and an illness duration of <1 year.
authors: Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, Faculty of Medicine, University of Tokyo, Tokyo, Japan.
authors: Ko
authors: K
authors: Matsudaira
authors: Department of Orthopaedic Surgery, Musashino Red Cross Hospital, Tokyo, Japan.
authors: Nobuhiro
authors: N
authors: Hara
authors: Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, Faculty of Medicine, University of Tokyo, Tokyo, Japan.
authors: Hiroyuki
authors: H
authors: Oka
authors: Department of Spine and Orthopaedic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan.
authors: Junichi
authors: J
authors: Kunogi
authors: Department of Orthopaedic Surgery, Musashino Red Cross Hospital, Tokyo, Japan.
authors: Takashi
authors: T
authors: Yamazaki
authors: Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan.
authors: Katsushi
authors: K
authors: Takeshita
authors: Department of Orthopaedic Surgery, Mitsui Memorial Hospital, Tokyo, Japan.
authors: Seichi
authors: S
authors: Atsushi
authors: Department of Orthopaedic Surgery, University of Tokyo, Tokyo, Japan.
authors: Sakae
authors: S
authors: Tanaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000527:Alprostadil / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008159:Lumbar Vertebrae / Q000187:drug effects / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D012600:Scoliosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D013130:Spinal Stenosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D013168:Spondylolisthesis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000527:Alprostadil