Introduction: Treatment for degenerative lumbar spinal stenosis (LSS) typically begins with conservative care and progresses to minimally invasive procedures, including interspinous spacer without decompression or fusion (ISD) or minimally invasive lumbar decompression (MILD). This study examined safety outcomes and the rate of subsequent spinal procedures among LSS patients receiving an ISD versus MILD as the first surgical intervention.
Methods: 100% Medicare Standard Analytical Files were used to identify patients with an ISD or MILD (first procedure=index date) from 2017 to 2021. ISD and MILD patients were matched 1:1 using propensity score matching based on demographics and clinical characteristics. Safety outcomes and subsequent spinal procedures were captured from index date until end of follow-up. Cox models were used to analyze rates of subsequent surgical interventions, LSS-related interventions, open decompression, fusion, ISD, and MILD. Cox models were used to assess postoperative complications during follow-up and logistic regression to analyze life-threatening complications within 30 days of index procedure.
Results: A total of 3682 ISD and 5499 MILD patients were identified. After matching, 3614 from each group were included in the analysis (mean age=74 years, mean follow-up=20.0 months). The risk of undergoing any intervention, LSS-related intervention, open decompression, and MILD were 21%, 28%, 21%, and 81% lower among ISD compared with MILD patients. Multivariate analyses showed no significant differences in the risk of undergoing fusion or ISD, experiencing postoperative complications, or life-threatening complications (all p≥0.241) between the cohorts.
Conclusions: These results showed ISD and MILD procedures have an equivalent safety profile. However, ISDs demonstrated lower rates of open decompression and MILD.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10850670 | PMC |
| http://dx.doi.org/10.1136/rapm-2022-104236 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Clinical Manifestations.
Alzheimers Dement
December 2024
Banner Alzheimer's Institute, Phoenix, AZ, USA.
Intrasubject variability is an important, but often overlooked, measure that has shown to be predictive of important clinical outcomes in ADRD research. Intrasubject variability is often quantified using the intrasubject standard deviation (ISD) that is derived from longitudinal measures or cross-sectional observations from similarly scaled variables. This talk will begin with an overview of ISD and its application in both longitudinal and cross-sectional analyses.
View Article and Find Full Text PDFClinical Manifestations.
Alzheimers Dement
December 2024
Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn Medical Center, Bonn, Germany.
Background: The identification of cognitively unimpaired individuals at risk of short-term cognitive decline is a critical task for Alzheimer´s disease (AD) research. Cognitively normal individuals with amyloid and/or tau pathology have a high risk for short-term cognitive decline. However, not all of these individuals show clinical progression.
View Article and Find Full Text PDFPerivascular space enlargement accelerates in ageing and Alzheimer's disease pathology: evidence from a three-year longitudinal multicentre study.
Alzheimers Res Ther
October 2024
German Centre for Neurodegenerative Diseases (DZNE), Leipziger Str. 44, Magdeburg, 39120, Germany.
Background: Perivascular space (PVS) enlargement in ageing and Alzheimer's disease (AD) and the drivers of such a structural change in humans require longitudinal investigation. Elucidating the effects of demographic factors, hypertension, cerebrovascular dysfunction, and AD pathology on PVS dynamics could inform the role of PVS in brain health function as well as the complex pathophysiology of AD.
Methods: We studied PVS in centrum semiovale (CSO) and basal ganglia (BG) computationally over three to four annual visits in 503 participants (255 females; mean = 70.
Association of Neurogranin and BACE1 With Clinical Cognitive Decline in Individuals With Subjective Cognitive Decline.
Neurology
October 2024
From the Department of Psychiatry and Neurosciences (X.W., S.D.F., L.-S.S., L.P., O.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Experimental and Clinical Research Center (ECRC) (X.W., S.D.F., L.-S.S., L.P., O.P.); German Center for Neurodegenerative Diseases (DZNE) (S.D.F., J.P., E.J.S., S.A., O.P.); Department of Psychiatry and Psychotherapy (J.P., E.J.S., S.A.), Charité, Berlin; Department of Psychiatry and Psychotherapy (J.P.), School of Medicine, Technical University of Munich, Germany; University of Edinburgh and UK DRI (J.P.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (A. Schneider, K.F., F.J., A. Spottke, N.R.-K., F.B., M.W., S.W., A. Ramirez, L.K., M.S.), Bonn; Department of Neurodegenerative Disease and Geriatric Psychiatry (A. Schneider, K.F., M.W., S.W., A. Ramirez, L.K., M.S.), University of Bonn Medical Center; German Center for Neurodegenerative Diseases (DZNE) (J.W.), Goettingen; Department of Psychiatry and Psychotherapy (J.W., N.H.), University Medical Center Goettingen, University of Goettingen, Germany; Neurosciences and Signaling Group (J.W.), Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Portugal; Department of Psychiatry (F.J., A. Rostamzadeh), Medical Faculty, University of Cologne; Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD) (F.J., A. Ramirez), University of Cologne, Köln; German Center for Neurodegenerative Diseases (DZNE) (E.D., W.G., E.I.I.), Magdeburg; Institute of Cognitive Neurology and Dementia Research (IKND) (E.D., E.I.I.), Otto-von-Guericke University, Magdeburg; Department for Psychiatry and Psychotherapy (E.I.I.), University Clinic Magdeburg; German Center for Neurodegenerative Diseases (DZNE) (K.B., M.E., R.P.), Munich; Institute for Stroke and Dementia Research (ISD) (K.B., D.J., M.E.), and Department of Psychiatry and Psychotherapy (R.P., B.-S.R.), University Hospital, LMU Munich; Munich Cluster for Systems Neurology (SyNergy) (R.P.), Germany; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R.), University of Sheffield, United Kingdom; Department of Neuroradiology (B.-S.R.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (DZNE) (S.J.T., I.K., D.G.), Rostock; Department of Psychosomatic Medicine (S.J.T., I.K., D.G.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (DZNE) (C.L., M.H.J.M.), Tübingen; Section for Dementia Research (C.L.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy (C.L., M.H.J.M.), University of Tübingen; Department of Neurology (A. Spottke), University of Bonn, Germany; Luxembourg Centre for Systems Biomedicine (LCSB) (M.T.H.), University of Luxembourg, Belvaux; Division of Neurogenetics and Molecular Psychiatry (A. Ramirez), Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; and Department of Psychiatry & Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (A. Ramirez), San Antonio, TX.
Article Synopsis
- The study investigates the potential of cerebrospinal fluid (CSF) biomarkers, particularly neurogranin and BACE1, to predict cognitive decline in individuals with subjective cognitive decline (SCD) before developing Alzheimer's disease (AD).
- Researchers analyzed data from 530 participants and found that higher levels of neurogranin and its ratio to BACE1 were linked to faster cognitive decline and increased risk of progressing from SCD to mild cognitive impairment (MCI).
- The findings suggest that monitoring neurogranin levels could help in identifying those at greater risk for cognitive decline, potentially aiding in earlier diagnosis and intervention for Alzheimer's disease.
Impact of Racial and Socioeconomic Disparities on Access to Interspinous Spacer for Treatment of Lumbar Spinal Stenosis: A Nationwide Medicare Analysis.
J Racial Ethn Health Disparities
July 2024
Brigham and Women's Center for Pain Medicine, Chestnut Hill, MA, USA.
Background: In mild to moderate lumbar spinal stenosis (LSS) where conservative care treatments fail, minimally invasive treatments, such as interspinous spacers without decompression or fusion (ISD), may be appropriate. While previous studies have demonstrated racial and socioeconomic disparities in the surgical treatment of LSS, there are limited data on how those factors impact accessibility to these procedures. This study explored demographic, socioeconomic, and geographic differences in the use of ISD.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!