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CompletedNCT02006901Updated Apr 8, 2015

Comparative Effectiveness of Microdecompression and Laminectomy for Central Lumbar Spinal Stenosis

An observational study in Spinal Stenosis and Spinal Cord Compression, sponsored by St. Olavs Hospital. Completed at 1 site in Norway. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2015-04-08.

Sponsored by St. Olavs Hospital · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
721
Ages
18 Years and older
Sex
All
01

Study summary

Introduction: This observational study is designed to test the equivalence between the clinical effectiveness of microdecompression and laminectomy in the surgical treatment of central lumbar spinal stenosis. Lumbar spinal stenosis is the most frequent indication for spinal surgery in the elderly, and as the oldest segment of the population continues to grow its prevalence is likely to increase. However, data on surgical outcomes are limited. Open or wide decompressive laminectomy, often combined with medial facetectomy and foraminotomy, was formerly the standard treatment. In recent years a growing tendency towards less invasive decompressive procedures has emerged. Many spine surgeons today perform microdecompression for central lumbar spinal stenosis.

Prospectively registered treatment and outcome data are obtained from the Norwegian Registry for Spine Surgery (NORspine).

02

Conditions studied

  • Spinal Stenosis
  • Spinal Cord Compression

Keywords

  • surgical procedures, operative
  • lumbar vertebrae
  • decompression, surgical
  • microdecompression
  • laminectomy
  • registries
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

patients who had operation in ≤2 lumbar levels with either open decompressive laminectomy, bilateral microdecompression or unilateral microdecompression for bilateral decompression in Norway in the time period between October 2006 and December 2011

Inclusion criteria

  • Diagnosis of central lumbar spinal stenosis
  • Operation in ≤2 lumbar levels with either open decompressive laminectomy, bilateral microdecompression or unilateral microdecompression for bilateral decompression in the time period between October 2006 and December 2011
  • Included in the NORspine registry

Exclusion criteria

Exclusion Criteria:

  • History of lumbar fusion
  • Previous surgery in the lumbar spine
  • Discectomy as part of the decompression
  • Associated pathological entities such as disc herniation, spondylolisthesis or scoliosis.
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
721 participants (actual)
Patient registry
No

Groups and cohorts

  • microdecompression

    surgical microdecompression using a bilateral or unilateral approach depending on the surgeon's preference and the individual patient's anatomy and symptoms.

    Procedure: microdecompression

  • laminectomy

    the spinous process and the laminae of the involved level(s) as well as the medial aspects of the facet joints are resected

    Procedure: laminectomy

Interventions

  • Proceduremicrodecompression

    a minimal invasive surgical technique

  • Procedurelaminectomy

    The traditional open surgical technique: decompression with removal of the spinous process, lamina and often the medial facets

05

What researchers measure

Primary outcomes

  1. change in Oswestry Disability Index

    collected through the Norwegian Registry for Spine Surgery (NORspine)

    Time frame: between baseline and 12-months follow-up

Secondary outcomes

  1. changes in health-related quality of life

    measured by Euro-Qol-5D, collected through the Norwegian Registry for Spine Surgery (NORspine)

    Time frame: between baseline and 12-months follow-up

  2. patient reported post-operative complications

    wound infection, urinary tract infection, pneumonia, pulmonary embolism, and deep venous thrombosis

    Time frame: 3 months

  3. surgeon reported complication

    intraoperative hemorrhage requiring blood replacement, unintentional durotomy, cardiovascular complications, respiratory complications, anaphylactic reactions, and wrong level surgery

    Time frame: reported at discharge (expected average hospital stay of 3 days)

  4. Length of hospital stay

    Length of hospital stay before discharge

    Time frame: reported at discharge (expected average hospital stay of 3 days)

  5. Length of surgery

    Length of surgery

    Time frame: reported at discharge (expected average hospital stay of 3 days)

06

Study locations

1 site
  • St.Olavs Hospital
    Trondheim, Norway
07

References and documents

Publications

  • Nerland US, Jakola AS, Solheim O, Weber C, Rao V, Lonne G, Solberg TK, Salvesen O, Carlsen SM, Nygaard OP, Gulati S. Minimally invasive decompression versus open laminectomy for central stenosis of the lumbar spine: pragmatic comparative effectiveness study. BMJ. 2015 Apr 1;350:h1603. doi: 10.1136/bmj.h1603. PubMed 25833966 ↗
  • Nerland US, Jakola AS, Solheim O, Weber C, Rao V, Lonne G, Solberg TK, Salvesen O, Carlsen SM, Nygaard OP, Gulati S. Comparative effectiveness of microdecompression and laminectomy for central lumbar spinal stenosis: study protocol for an observational study. BMJ Open. 2014 Mar 20;4(3):e004651. doi: 10.1136/bmjopen-2013-004651. PubMed 24650809 ↗
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Registry details

Key details

Study ID
NCT02006901
Lead sponsor
St. Olavs Hospital
Collaborators
Norwegian University of Science and Technology
Responsible party
Sponsor
First posted
Dec 10, 2013
Start date
Jan 2014
Primary completion
Jan 2015
Completion
Jan 2015
Last update
Apr 8, 2015

Study contacts

Sasha Gulati, MD, PhD
principal investigator · St. Olavs Hospital

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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