ISSN 2147-9720 | E-ISSN 2148-4279
Original Article
Surgery for lumbar spinal stenosis in patients with rheumatoid arthritis: A multicenter observational study
1 Department of Rheumatology, St. Olavs University Hospital, Trondheim, Norway; Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway  
2 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  
3 Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway  
4 Department of Rheumatology, St. Olavs University Hospital, Trondheim, Norway; Department of Public Health and General Practice, NTNU, Trondheim, Norway  
5 Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Rheumatology, Martina Hansens Hospital, Baerum, Norway  
Eur J Rheumatol 2016; 3: 56-60
DOI: 10.5152/eurjrheum.2016.15070
Key Words: Rheumatoid arthritis, spinal stenosis, spondylosis, quality of life, neurosurgical procedures
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.

 

Material and 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).

 

Conclusion: 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.

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