Appendix: Questionnaire degenerative lumbar stenosis
Name:
Sex: M/F
Years of clinical practice:……………………………………………………………………...
1. How many decompressions for degenerative lumbar stenosis do you perform annually?
2. Which surgical technique do you perform as standard procedure?
usually sometimes never
Total laminectomy and medial facetectomy c c c
Total laminectomy c c c
Interlaminar decompression c c c
Bilateral laminotomy c c c
Unilateral laminotomy c c c
Stand alone IPD (interspinous process device) c c c
Conventional decompression and IPD c c c
Microendoscopic decompression c c c
3. In how many cases do you perform concomitant fusion with pedicle screws annually?
4. For which indications do you consider concomitant fusion necessary? (multiple answers possible)
p Documented vertebral instability with flexion/extension radiographs
p spondylolisthesis grade 1
p spondylolisthesis ≥ grade 2
p Isthmic spondylolisthesis without documented vertebral instability
p Severe back pain
p I don’t perform fusion procedures
5. How often do you perform indirect decompression with interspinous process devices annually?
6. For which indications do you consider using an interspinous process device? (multiple answers possible)
p Neurogenic claudication
p Back pain/facet pain
p Decompression of foraminal stenosis
p As part of an instrumented fusion procedure
p As part of an dynamic fusion procedure
p After discectomy (‘hernia plus’ procedure)
p Not applicable
7. Which interspinous process device do you use?
p X-stop
p Coflex
p Aperius
p Diam
p Wallis
p Backjack
p Wellex
p Flexis
p Dynafix
p ExtenSure
p InSpace
p Superion
p ISS
p VertiFlex
p LLograf
p Flexus
p Ceramic
p Other…
8. What is the expected effectiveness of the following techniques according to you?
most least
Total laminectomy and medial facetectomy c c c c c
Total laminectomy c c c c c
Interlaminar decompression c c c c c
Bilateral laminotomy c c c c c
Unilateral laminotomy c c c c c
Indirect decompression with IPD c c c c c
Microendoscopic decompression c c c c c
9. What is the expected postoperative low back pain of the following techniques according to you?
most least
Total laminectomy and medial facetectomy c c c c c
Total laminectomy c c c c c
Interlaminar decompression c c c c c
Bilateral laminotomy c c c c c
Unilateral laminotomy c c c c c
Indirect decompression with IPD c c c c c
Microendoscopic decompression c c c c c
10. What is the expected complication risk of the following techniques according to you?
most least
Total laminectomy and medial facetectomy c c c c c
Total laminectomy c c c c c
Interlaminar decompression c c c c c
Bilateral laminotomy c c c c c
Unilateral laminotomy c c c c c
Indirect decompression with IPD c c c c c
Microendoscopic decompression c c c c c
11. What proportion of patients report satisfactory relief of symptoms after 8 weeks according to you?
12. What proportion of patients report satisfactory relief of symptoms after 5 years according to you?
13. Which clinical aspects of lumbar stenosis do you consider important indications for surgical treatment? most least
Duration of symptoms c c c c c
Severity of pain/disability c c c c c
Typical neurogenic claudication c c c c c
Extent of stenosis (MRI) c c c c c
Presence of spondylolisthesis/scoliosis c c c c c
Patient’s preference for treatment c c c c c
Failure of conservative treatment c c c c c
Patient’s age c c c c c
Presence of co morbid condition c c c c c
14. Do you consider conservative treatment a pre-requisite to surgical treatment? (multiple answers possible)
p Yes, in all cases
p Yes, but only in case of moderate symptom severity
p Yes, but only in case of moderate constriction of the spinal canal
p No
15. What are the minimum requirements of conservative treatment according to you?
p At least 3 months of treatment by a physician or physical therapist
p At least 6 months of treatment by a physician or physical therapist
p At least 3 months of symptoms
p At least 6 months of symptoms
16. What is the expected effectiveness of the following conservative treatments according to you?
most least
Counseling by general practitioner or neurologist c c c c c
Physical therapy c c c c c
Pain medication c c c c c
Steroid injections c c c c c
Use of an orthesis c c c c c
17. How do patient and anatomical characteristics affect outcome of non-surgical treatment according to you?
good outcome bad outcome
Severe symptoms c c c c c
Long-lived symptoms c c c c c
Young patients (<70) c c c c c
Older patients (>70) c c c c c
Severe constriction of the spinal canal c c c c c
Stenosis of multiple spinal levels c c c c c
Presence of spondylolisthesis/scoliosis c c c c c
Recurrent symptoms following decompression c c c c c
Patient’s preference for surgical treatment c c c c c