Orthosis as prognostic instrument in lumbar fusion: no predictive value in 50 cases followed prospectively.
To evaluate pain relief in a lumbar orthosis as a predictor for good clinical results after solid fusion, all patients scheduled for such a surgical procedure were preoperatively encouraged to use an orthosis, soft or rigid, for 3 weeks. Grade of back pain relief as a percent using the orthosis was assessed by the patients and was registered before surgery. After surgery, at 1-year follow-up, patients with nonunion demonstrated radiographically were excluded from the series. Thus, 50 patients with solid fusion could be identified and followed for at least 2 years prospectively. At follow-up these 50 patients graded the pain relief induced by the fusion. In the preoperative corset test, 31 patients experienced significant back pain relief, meaning a reduction of at least 50%. No applicable correlation was found, however, between outcome in this corset test and the eventual clinical result expressed as improvement/no improvement after solid fusion. The two types of orthoses did not differ in this aspect. We conclude that the orthosis, rigid or soft, is not a useful instrument when selecting patients for lumbar fusion.
Department of Orthopedics, Lund University Hospital, Sweden.
P
P
Axelsson
R
R
Johnsson
B
B
Strömqvist
L T
LT
Nilsson
M
M
Akesson
D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D006801:Humans; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D013123:Spinal Fusion