title: Utility of spine surgery: a comparison of common elective orthopaedic surgical procedures.
abstract: METHODS
  A 1-year prospective observational cohort study.
  
  
  OBJECTIVE
  To compare the utility before and 1 year after elective spine surgery with some other common orthopaedic surgical procedures.
  
  
  BACKGROUND
  By using global measures like EQ-5D and SF-36 for the determination of the utility, the changes in quality of life, quality of life (QoL) after an intervention different diagnoses, and treatments can be compared. Total hip replacement (THR) has become almost golden standard in this respect.
  
  
  METHODS
  Seven hundred seventy-seven subjects with different common orthopaedic diagnoses scheduled for elective surgery were just before surgery and 1 year after surgery answering both EQ-5D and SF-36. Four groups with different spine diagnoses and procedures were formed and compared with 8 other diagnoses and treatment groups.
  
  
  RESULTS
  Before surgery, subjects with spine diagnoses reported the lowest QoL of all diagnoses compared. Surgery for spinal stenosis, spondylolisthesis, and instability meant the largest improvement of all surgical interventions. Surgery for NHP gave a moderately good improvement, whereas surgery for CLBP only marginally improved those operated. Particularly THR but also TKR more or less completely normalized QoL but made it from a relatively high preoperative level. The greatest improvements after spine surgery, other surgical procedures, and different diagnoses were in the pain/discomfort domain.
  
  
  CONCLUSIONS
  Spinal surgery in spinal stenosis, spondylolisthesis, and instability had in comparison to other types of elective orthopaedic surgery an outstanding better ability to improve the operated subject's health-related quality of life than other types of elective orthopaedic surgery. The utility of HNP surgery was somewhat lower and was rather marginal for those operated for nonspecific CLBP.
authors.affiliation: Department of Orthopaedics, Sahlgrenska Academy, Göteborg, Sweden. tommy.hansson@orthop.gu.se
authors.forename: Tommy
authors.initials: T
authors.lastname: Hansson
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Hansson
authors.forename: Henrik
authors.initials: H
authors.lastname: Malchau
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003937:Diagnosis, Differential; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D017116:Low Back Pain / Q000175:diagnosis / Q000523:psychology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D013122:Spinal Diseases / Q000175:diagnosis / Q000523:psychology / Q000601:surgery*; D055815:Young Adult