title: Differences in post-operative functional disability and patient satisfaction between patients with long (three levels or more) and short (less than three) lumbar fusions.
abstract: We examined the differences in post-operative functional disability and patient satisfaction between 56 patients who underwent a lumbar fusion at three or more levels for degenerative disease (group I) and 69 patients, matched by age and gender, who had undergone a one or two level fusion (group II). Their mean age was 66 years (49 to 84) and the mean follow-up was 43 months (24 to 65). The mean pre-operative Oswestry Disability Index (ODI) and visual analogue scale (VAS) for back and leg pain, and the mean post-operative VAS were similar in both groups (p > 0.05), but post-operatively the improvement in ODI was significantly less in group I (40.6%) than in group II (49.5%) (p < 0.001). Of the ten ODI items, patients in group I showed significant problems with lifting, sitting, standing, and travelling (p < 0.05). The most significant differences in the post-operative ODI were observed between patients who had undergone fusion at four or more levels and those who had undergone fusion at less than four levels (p = 0.005). The proportion of patients who were satisfied with their operations was similar in groups I and II (72.7% and 77.0%, respectively) (p = 0.668). The mean number of fused levels was associated with the post-operative ODI (r = 0.266, p = 0.003), but not with the post-operative VAS or satisfaction grade (p > 0.05). Post-operative functional disability was more severe in those with a long-level lumbar fusion, particularly at four or more levels, but patient satisfaction remained similar for those with both long- and short-level fusions.
authors.affiliation: Department of Orthopedic Surgery, Spine Center, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Ilwon-dong 50, Kangnam-Gu, Seoul 135-710, Korea.
authors.forename: C S
authors.initials: CS
authors.lastname: Lee
authors.forename: S S
authors.initials: SS
authors.lastname: Chung
authors.forename: S K
authors.initials: SK
authors.lastname: Shin
authors.forename: S J
authors.initials: SJ
authors.lastname: Park
authors.forename: H I
authors.initials: HI
authors.lastname: Lee
authors.forename: K C
authors.initials: KC
authors.lastname: Kang
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D020127:Recovery of Function; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000534:rehabilitation / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods* / Q000534:rehabilitation; D016896:Treatment Outcome