title: Disc height and sagittal alignment in operated and non-operated levels in the lumbar spine at long-term follow-up: a case-control study.
abstract: OBJECTIVE
  To compare lumbar disc degeneration at 9-year follow-up in patients with chronic low back pain who had instrumented lumbar fusion or no fusion.
  
  
  METHODS
  The main outcomes were disc height and sagittal alignment measured by Distortion Compensated Roentgen Analysis (DCRA). Secondary outcome included the Oswestry Disability Index and VAS back pain.
  
  
  RESULTS
  Forty-eight patients with baseline and 9-year radiographs from L2- S1 were included. Twenty-three had lumbar fusion and 25 had no fusion. Disc height was reduced at all levels independent of fusion. No difference in disc height and sagittal alignment was observed between patients fused and not fused. There were weak correlations, ranging from 0.04 to 0.36, between clinical and radiological parameters.
  
  
  CONCLUSIONS
  Lumbar disc degeneration increased at all measured levels independent of fusion and correlated poorly with clinical outcome.
authors: Division of Orthopaedic Surgery, Oslo University Hospital, Rikshospitalet, Norway ; Department of Physical Medicine and Rehabilitation, Drammen Hospital, Vestre Viken Trust, Norway.
authors: Anne
authors: A
authors: Froholdt
authors: Jens Ivar
authors: JI
authors: Brox
authors: Olav
authors: O
authors: Reikerås
authors: Gunnar
authors: G
authors: Leivseth
keywords: Chronic low back pain; cognitive; disc degeneration; exercise; fusion; long term.
references: Ann Rheum Dis. 2011 Jul;70(7):1203-7
references: 21402564
references: Spine J. 2005 Jan-Feb;5(1):24-35
references: 15653082
references: J Neurosurg Spine. 2009 Oct;11(4):501-7
references: 19929349
references: BMJ. 2005 May 28;330(7502):1233
references: 15911537
references: Spine (Phila Pa 1976). 2004 Jul 15;29(14):1535-40
references: 15247575
references: Eur Spine J. 2005 Feb;14(1):27-35
references: 15723249
references: Spine (Phila Pa 1976). 1998 Dec 1;23(23):2648-55
references: 9854765
references: Ann Rheum Dis. 2011 Oct;70(10):1740-5
references: 21646416
references: Arthritis Rheum. 1999 Feb;42(2):366-72
references: 10025932
references: Eur Spine J. 2007 Dec;16(12):2152-8
references: 17922149
references: Spine (Phila Pa 1976). 2007 Mar 1;32(5):574-9
references: 17334293
references: Spine (Phila Pa 1976). 2003 Sep 1;28(17):1913-21
references: 12973134
references: Spine (Phila Pa 1976). 2007 Mar 1;32(5):512-7
references: 17334284
references: Ann Rheum Dis. 2010 Sep;69(9):1643-8
references: 19635718
references: Clin Biomech (Bristol, Avon). 1997;12 Suppl 1:S1-S63
references: 11430783
references: Pain. 2006 May;122(1-2):145-55
references: 16545523
references: Eur Spine J. 2009 Aug;18(8):1175-86
references: 19337757
references: Orthop Clin North Am. 2011 Oct;42(4):529-41, viii
references: 21944589
references: Eur Spine J. 2012 Aug;21 Suppl 6:S810-8
references: 21837413
references: Spine (Phila Pa 1976). 2004 Dec 1;29(23):2724-32
references: 15564921
references: Physiotherapy. 1980 Aug;66(8):271-3
references: 6450426
references: Spine (Phila Pa 1976). 2001 Dec 1;26(23):2521-32; discussion 2532-4
references: 11725230
references: Spine (Phila Pa 1976). 1991 Jun;16(6):629-34
references: 1862401
references: Spine (Phila Pa 1976). 2000 Jan 15;25(2):218-23
references: 10685487
references: Bull NYU Hosp Jt Dis. 2007;65(1):29-36
references: 17539759
references: Eur Spine J. 2001 Aug;10(4):309-13
references: 11563616
references: Spine (Phila Pa 1976). 2004 Dec 1;29(23):2679-90
references: 15564917
references: Connect Tissue Res. 2010 Dec;51(6):467-77
references: 20604714
references: Spine J. 2011 Nov;11(11):991-8
references: 21978518