A1 Journal article (refereed)
Benefits of Lumbar Spine Fusion Surgery Reach 10 Years with Various Surgical Indications (2023)
Toivonen, L., Häkkinen, A., Pekkanen, L., Kyrölä, K., Kautiainen, H., & Neva, M. H. (2023). Benefits of Lumbar Spine Fusion Surgery Reach 10 Years with Various Surgical Indications. North American Spine Society Journal, 16, Article 100276. https://doi.org/10.1016/j.xnsj.2023.100276
JYU authors or editors
Publication details
All authors or editors: Toivonen, Leevi; Häkkinen, Arja; Pekkanen, Liisa; Kyrölä, Kati; Kautiainen, Hannu; Neva, Marko H.
Journal or series: North American Spine Society Journal
eISSN: 2666-5484
Publication year: 2023
Publication date: 09/09/2023
Volume: 16
Article number: 100276
Publisher: Elsevier
Publication country: United States
Publication language: English
DOI: https://doi.org/10.1016/j.xnsj.2023.100276
Publication open access: Openly available
Publication channel open access: Open Access channel
Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/90113
Abstract
Lumbar spine fusion (LSF) surgery is a viable form of treatment for several spinal disorders. Treatment effects are preferably to be endorsed in real-life settings.
Methods
This prospective study evaluated the 10-year outcomes of LSF. A population-based series of elective LSFs performed at 2 spine centers between January 2008 and June 2012 were enrolled. Surgeries for tumor, acute fracture or infection, neuromuscular scoliosis, or postoperative conditions were excluded. The following patient-reported outcome measures (PROMs) were collected at baseline, and 1, 2, 5, and 10 years postsurgery: VAS for back and leg pain, ODI, SF-36. Longitudinal measures of PROMs were analyzed using mixed-effects models.
Results
683 patients met the inclusion criteria, and 630 (92%) of them completed baseline and at least one f-u PROMs, and they constituted the study population. Mean age was 61 (SD 12) years, 69% women. According to surgical indication, patients were stratified into degenerative spondylolisthesis (DS, n=332, 53%), spinal stenosis (SS, n=102, 16%), isthmic spondylolisthesis (IS, n=97, 15%), degenerative disc disease (DDD, n=52, 8%), and deformity (DF, n=47, 7%).
All diagnostic cohorts demonstrated significant improvement at 1 year, followed by a partial loss of benefits by 10 years. ODI baselines and changes at 1 and 10 years were: (DS) 45, -21, and -14; (SS) 51, -24, and -13; (IS) 41, -24, and -20; (DDD) 50, -20, and -20; and (DF) 50, -21, and -16, respectively. Comparable patterns were seen in pain scores. Significant HRQoL achievements were recorded in all cohorts, greatest in physical domains, but also substantial in mental aspects of HRQoL.
Conclusions
Benefits of LSF were partially lost but still meaningful at 10 years of surgery. Long-term benefits seemed milder with degenerative conditions, reflecting the progress of the ongoing spinal degeneration. Benefits were most overt in pain and physical function measures.
Keywords: spine; lumbar vertebrae; spinal diseases; surgical treatment
Free keywords: lumbar spine fusion; long-term; outcome; patient reported outcomes; PROM; indication
Contributing organizations
Ministry reporting: Yes
VIRTA submission year: 2023
JUFO rating: 1
