Outcome of spinal fusion for lumbar degenerative disease: a cross-sectional study in Korea.
METHODS
Retrospective cross-sectional study.


OBJECTIVE
To evaluate the degree of postoperative pain and patients' satisfaction after lumbar fusion from a nationwide survey in Korea.


BACKGROUND
There have been few studies that investigated the factors related to patients' satisfaction after spinal fusion in lumbar degenerative disease (LDD).


METHODS
This study included 629 patients who underwent spinal fusion for LDD at clinics of designated members of the Korean Society of Spine Surgery. This survey was done in 123 hospitals with 171 spine surgeons. Questionnaires for patients included severity of present back pain and radicular pain (visual analog scale score), Oswestry Disability Index (ODI), and subjective outcomes. Questionnaire for surgeons included preoperative diagnosis, level of fusion, operative method, and presumed patient's pain.


RESULTS
The patients were 199 men and 430 women, with mean age of 62.3 years. The mean visual analog scale score of back pain and radicular pain was 5.0 +/- 2.6 and 4.4 +/- 3.0, respectively. The mean ODI was 44.3 +/- 19.4. ODI was significantly increased with older age, workers' compensation, and increased fusion extent. Correlated factors of dissatisfaction were severe back pain, higher ODI, multiple operation, and insufficient explanation about postoperative pain. There was a significant correlation between preoperative explanation about postoperative pain and degree of patient's pain.


CONCLUSIONS
Patients' satisfaction was not as high as expected after fusion for LDD. Therefore, the decision for performing a lumbar fusion in those patients must be done more carefully, and it should be explained more precisely that chronic pain may persist after spinal surgery.
Department of Orthopaedic Surgery, Seoul National University, Seoul, Republic of Korea.
Chang-Bae
CB
Kong
Do-Whan
DW
Jeon
Bong-Soon
BS
Chang
Jae Hyup
JH
Lee
Kyung-Soo
KS
Suk
Jong-Beom
JB
Park
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000601:surgery; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000601:surgery*; D007723:Korea; D016015:Logistic Models; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013123:Spinal Fusion; D011795:Surveys and Questionnaires; D055815:Young Adult