title: Membrane-Stabilizing Agents Improve Quality-of-Life Outcomes for Patients with Lumbar Stenosis.
abstract: Study Design Retrospective cohort controlled study. Objective To determine quality-of-life (QOL) outcomes for patients with lumbar spinal stenosis (LSS) treated with membrane-stabilizing agents (MSAs). Methods Patients with LSS and concordant neurogenic claudication treated with MSAs (n = 701) or conservatively without MSAs (n = 2104) at a single tertiary care hospital were identified. Patient QOL measures (Patient Health Questionnaire-9 [PHQ9], EuroQOL-5 Dimensions [EQ-5D], Pain Disability Questionnaire [PDQ]) were recorded pretreatment and then 4 months following treatment. Propensity score matching was used to account for baseline demographic differences between the two groups. The primary outcome measure was posttreatment improvement in these QOL measures. Results Patients in both groups had statistically significant improvements in the EQ-5D. However, the EQ-5D improvement in the MSA group was significantly greater than the improvement in the control group (0.11 versus 0.06; p = 0.0494). The EQ-5D change in the MSA group also exceeded the minimum clinically important difference, thereby suggesting a clinical significance. Both groups had significant pre- to posttreatment improvements in PDQ and PHQ-9, but these changes were not significantly different between the groups. Conclusion The results of this study suggest that patients with LSS and neurogenic claudication can have greater QOL improvements when treated with MSAs compared with other forms of conservative management without MSAs.
authors.affiliation: Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, Ohio, United States.
authors.forename: Sachin
authors.initials: S
authors.lastname: Bansal
authors.affiliation: Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, Ohio, United States; Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States.
authors.forename: Daniel
authors.initials: D
authors.lastname: Lubelski
authors.affiliation: Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, United States; Neurolgical Institute Center for Outcomes Research and Evaluation, Cleveland Clinic, Cleveland, Ohio, United States.
authors.forename: Nicolas R
authors.initials: NR
authors.lastname: Thompson
authors.affiliation: Good Shepherd Spine and Joint Center, Allentown, Pennsylvania, United States.
authors.forename: Ali A
authors.initials: AA
authors.lastname: Shah
authors.affiliation: Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, Ohio, United States; Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Mazanec
authors.affiliation: Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, Ohio, United States; Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States.
authors.forename: Edward C
authors.initials: EC
authors.lastname: Benzel
authors.affiliation: Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, Ohio, United States; Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States.
authors.forename: Tagreed
authors.initials: T
authors.lastname: Khalaf
keywords: EQ-5D; Lyrica; Neurontin; membrane stabilizing agents; propensity score; quality of life