title: Is increased segmental motion early after lumbar discectomy related to poor clinical outcome 5 years later?
abstract: The purpose of the study was to compare segmental motion in the early postoperative phase after lumbar discectomy to the outcome 5 years postoperatively. The study population had radiologically verified symptomatic L4-L5 or L5-S1 lumbar disc herniation and was referred with an indication for lumbar discectomy. Radiostereometry was performed in the supine and standing positions. The L4-L5 and L5-S1 segments were analysed separately. L4-L5 segments adjacent to the operated L5-S1 segment constituted a reference segment for the operated L4-L5 and vice versa. Twenty-one patients were available for the follow-up at 5 years. Outcome was classified as functionally good or poor. Repeated or planned repeat surgery at the same level during follow-up was considered as poor outcome. The L4-L5 segments in the poor group showed different direction of sagittal rotation (anterior versus posterior) of L4 on L5 compared with the good group (p<0.01). On the L5-S1 segment, patients with poor outcome displayed an increased anterior translation of about 1 mm (p<0.01) compared with the reference segments. Our study suggests that increased inducible vertebral displacement in the early postoperative phase after discectomy is associated with a poor clinical outcome.
authors.affiliation: Department of Orthopaedics, Sahlgrenska University Hospital, Göteborg University, Bruna Stråket 11, 5e, 413 45 Göteborg, Sweden. klas.halldin@vgregion.se
authors.forename: K
authors.initials: K
authors.lastname: Halldin
authors.forename: B
authors.initials: B
authors.lastname: Zoëga
authors.forename: J
authors.initials: J
authors.lastname: Kärrholm
authors.forename: B I
authors.initials: BI
authors.lastname: Lind
authors.forename: P
authors.initials: P
authors.lastname: Nyberg
mesh_terms: D000328:Adult; D017586:Diskectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery; D007593:Joint Instability / Q000175:diagnosis* / Q000209:etiology; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D012447:Sacrum; D016896:Treatment Outcome