title: Surgery for lumbar spinal stenosis in patients with rheumatoid arthritis: A multicenter observational study.
abstract: OBJECTIVE
  To compare clinical outcomes following microdecompression surgery or laminectomy for central lumbar spinal stenosis (LSS) between patients with rheumatoid arthritis (RA) and patients without rheumatic disease.
  
  
  METHODS
  Data were collected from the Norwegian Registry for Spine Surgery. The primary outcome was change in the Oswestry Disability Index (ODI) score at 1 year. The secondary endpoints were health-related quality of life that was measured using the Euro-Qol-5D (EQ-5D), back pain numerical rating scale (NRS), leg pain NRS, and complications.
  
  
  RESULTS
  A total of 1433 patients were included (1396 controls and 37 patients with RA). For all the patients, there was an improvement in ODI score 16.7 points; 95% confidence interval (CI), 15.7, 17.7; p<0.001). There were no differences between controls and patients with RA with respect to the mean changes of ODI scores (-2.5 points; 95% CI, -9.0 to 4.1; p=0.462), EQ-5D (p=0.295), back pain NRS (p=0.194), leg pain NRS (p=0.927), and complications within 3 months of surgery (12.8% vs. 13.5%, p=0.806). At 1 year, 68.6% (n=775) of controls had achieved a minimal clinically important difference (≥8 points ODI score improvement) compared with 65.5% (n=19) of patients with RA (p=0.726).
  
  
  CONCLUSIONS
  Patients with RA experienced similar and large improvements in patient-reported outcomes following surgical decompression for LSS compared with patients without rheumatic disease. There was no increased risk of complications in patients with RA.
authors.affiliation: Department of Rheumatology, St. Olavs University Hospital, Trondheim, Norway; Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
authors.forename: Agnete
authors.initials: A
authors.lastname: Gulati
authors.affiliation: Department of Neurosurgery, University Hospital of Northern Norway (UNN), Tromso, Norway; The Norwegian National Registry for Spine Surgery (NORspine), University Hospital of Northern Norway (UNN), Tromso, Norway.
authors.forename: Tore
authors.initials: T
authors.lastname: Solberg
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway.
authors.forename: Charalampis
authors.initials: C
authors.lastname: Giannadakis
authors.affiliation: Department of Rheumatology, St. Olavs University Hospital, Trondheim, Norway; Department of Public Health and General Practice, NTNU, Trondheim, Norway.
authors.forename: Mari
authors.initials: M
authors.lastname: Hoff
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Rheumatology, Martina Hansens Hospital, Baerum, Norway.
authors.forename: Glenn
authors.initials: G
authors.lastname: Haugeberg
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway; National Advisory Unit on Spinal Surgery Center for Spinal Disorders, St. Olavs University Hospital, Trondheim, Norway.
authors.forename: Oystein
authors.initials: O
authors.lastname: Nygaard
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway; National Advisory Unit on Spinal Surgery Center for Spinal Disorders, St. Olavs University Hospital, Trondheim, Norway; Norwegian Centre of Competence in Deep Brain Stimulation for Movement Disorders, St. Olavs University Hospital, Trondheim, Norway.
authors.forename: Sasha
authors.initials: S
authors.lastname: Gulati
keywords: Rheumatoid arthritis; neurosurgical procedures; quality of life; spinal stenosis; spondylosis