title: Predictors of Oswestry Disability Index worsening after lumbar fusion.
abstract: The authors identified patients with an increase in their Oswestry Disability Index (ODI) score after lumbar spine fusion to evaluate whether this is a plausible definition of deterioration and to determine whether any common patient characteristics exist.A total of 1054 patients who underwent lumbar spinal fusion and had 2-year follow-up data, including the Short Form 36, the ODI, and numeric rating scales for back and leg pain, were identified. Patients with worsening ODI were compared with the remaining cohort. Twenty-eight patients had an absolute increase (worse) in ODI at 1 year postoperatively. Participants with worsening ODI scores included 13 men and 15 women with an average age of 43.3 years; 15 (54%) were smokers. Common medical comorbidities included obesity and hypertension. Complications occurred in 5 (18%) patients and included wound infection, dural tear, and nerve root injury. Pseudarthrosis was common (n=8; 28%). Twenty-one patients required an additional intervention, including epidural injections, fusion revision, and cervical spine surgery.It is important to have a clear definition of deterioration to better provide informed consent or choice of treatment. Only 28 (2.6%) patients were identified as having an increase in ODI score at 2-year follow-up.
authors.affiliation: Department of Orthopaedic Surgery, University of Louisville School of Medicine, Louisville, KY, USA.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Gum
authors.forename: Leah Y
authors.initials: LY
authors.lastname: Carreon
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Stimac
authors.forename: Steven D
authors.initials: SD
authors.lastname: Glassman
mesh_terms: D000328:Adult; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000009:adverse effects*