4.5 Article

The Norwegian degenerative spondylolisthesis and spinal stenosis (NORDSTEN) study: study overview, organization structure and study population

Journal

EUROPEAN SPINE JOURNAL
Volume -, Issue -, Pages -

Publisher

SPRINGER
DOI: 10.1007/s00586-023-07827-w

Keywords

Lumbar spinal stenosis; Degenerative spondylolisthesis; NORDSTEN organization; Randomized multicentre study; Observational cohort

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The Norwegian Degenerative spondylolisthesis and spinal stenosis (NORDSTEN) study is a multicenter study evaluating the effectiveness and natural course of treatment methods for lumbar spinal stenosis and degenerative spondylolisthesis. The study found no difference in efficacy between surgical methods and the NORDSTEN study population was similar to patients treated in routine surgical practice.
PurposeTo provide an overview of the The Norwegian Degenerative spondylolisthesis and spinal stenosis (NORDSTEN)-study and the organizational structure, and to evaluate the study population.MethodsThe NORDSTEN is a multicentre study with 10 year follow-up, conducted at 18 public hospitals. NORDSTEN includes three studies: (1) The randomized spinal stenosis trial comparing the impact of three different decompression techniques; (2) the randomized degenerative spondylolisthesis trial investigating whether decompression surgery alone is as good as decompression with instrumented fusion; (3) the observational cohort tracking the natural course of LSS in patients without planned surgical treatment. A range of clinical and radiological data are collected at defined time points. To administer, guide, monitor and assist the surgical units and the researchers involved, the NORDSTEN national project organization was established.Corresponding clinical data from the Norwegian Registry for Spine Surgery (NORspine) were used to assess if the randomized NORDSTEN-population at baseline was representative for LSS patients treated in routine surgical practice.ResultsA total of 988 LSS patients with or without spondylolistheses were included from 2014 to 2018. The clinical trials did not find any difference in the efficacy of the surgical methods evaluated. The NORDSTEN patients were similar to those being consecutively operated at the same hospitals and reported to the NORspine during the same time period.ConclusionThe NORDSTEN study provides opportunity to investigate clinical course of LSS with or without surgical interventions. The NORDSTEN-study population were similar to LSS patients treated in routine surgical practice, supporting the external validity of previously published results.

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