Browsing by Author "Ahlers, Kristian"
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Ahlers, Kristian (2019)The role of lumbar fusion in the treatment of degenerative lumbar conditions is still under debate with evidence both in favour and against the addition of fusion to decompressive surgery. Our aim was to assess the symptom-specific outcome for lumbar spinal fusion surgery at 3, 12 and 23 months and examine the rate of reoperations during a 7-year mean follow-up time span. We conducted an open-cohort retrospective study on 357 patients, who had undergone lumbar spinal fusion surgery for degenerative causes at the neurosurgical department of Töölö Hospital during 2007–2013. Patients were divided into four groups based on the baseline dominant symptom; stabbing back or radicular stabbing pain, non-stabbing back pain, radicular non-stabbing pain or neurosensory impairment, and radicular motor impairment. Outcome was assessed using a 3-tier Likert scale at 3, 12 and 23 months after the lumbar fusion operation. The baseline dominant symptom of stabbing back or radicular stabbing pain was associated with the most beneficial outcome at 12 and 23 months (p < 0.01). 19% of patients had undergone reoperations related to a degenerative lumbar condition within a mean of 7 years after the fusion surgery; 3% and 16% of patients within one month and after one month, respectively. In conclusion, spinal lumbar fusion was associated with the most beneficial outcome among patients with stabbing back or leg pain as the dominant baseline symptom. Patient-reported outcome measures and control for baseline characteristics are needed for stronger evidence in this subject.
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