[Can epidemiological factors affect the 2-year outcomes after surgery for degenerative lumbar disease in terms of quality of life, disability and post-surgical pain?].
OBJECTIVE
To evaluate the influence of epidemiological factors on the outcomes of surgery for degenerative lumbar disease in terms of quality of life, disability and chronic pain.


METHODS
A total of 263 patients who received surgery for degenerative lumbar disease (2005-2008) were included in the study. The epidemiological data collected were age, gender, employment status, and co-morbidity. The SF-36, Oswestry Disability Index (ODI), Core Outcomes Measures Index (COMI), and VAS score for lumbar and sciatic pain were measure before and 2 years after surgery. The correlation between epidemiological data and questionnaire results, as well as any independent prognostic factors, were assessed in the data analysis.


RESULTS
The mean age of the patients was 54.0 years (22-86), and 131 were female (49.8%). There were 42 (16%) lost to follow-up. Statistically significant correlations (P<.05) were observed between age, gender, co-morbidity, permanent sick leave, and pre-operative pain with changes in the ODI, COMI, physical and SF-36 mental scales, and lumbar and sciatic VAS. Linear regression analysis showed permanent sick leave and age as predictive factors of disability (β=14.146; 95% CI: 9.09 - 29.58; P<.01 and β=0.334; 95% CI: 0.40 - 0.98, P<.05, respectively), and change in quality of life (β=-8.568; 95% CI: -14.88 - -2.26; p<.01 and β=-0.228, IC 95% CI: -0.40 - -0.06, P<.05, respectively).


CONCLUSIONS
Based on our findings, age and permanent sick leave have to be considered as negative epidemiologic predictive factors of the outcome of degenerative lumbar disease surgery.
Orthopaedic Surgery and Trauma Deparment, University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, United Kingdom. Electronic address: carlos.lozano.alvarez@gmail.com.
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Lozano-Álvarez
Servicio de Cirugía Ortopédica y Traumatología Parc de Salut Mar (Hospitals del Mar i la Esperanza), Barcelona, España.
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Pérez-Prieto
Servicio de Cirugía Ortopédica y Traumatología Parc de Salut Mar (Hospitals del Mar i la Esperanza), Barcelona, España.
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Saló-Bru
Servicio de Cirugía Ortopédica y Traumatología Parc de Salut Mar (Hospitals del Mar i la Esperanza), Barcelona, España.
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Molina
Servicio de Cirugía Ortopédica y Traumatología Parc de Salut Mar (Hospitals del Mar i la Esperanza), Barcelona, España.
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Lladó
Universitat Autónoma de Barcelona (UAB), Barcelona, España; Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitari Vall d́Hebron, Barcelona, España.
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Cáceres
Servicio de Cirugía Ortopédica y Traumatología Parc de Salut Mar (Hospitals del Mar i la Esperanza), Barcelona, España.
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Ramírez
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000453:epidemiology / Q000601:surgery*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology*; D011788:Quality of Life; D012189:Retrospective Studies; D018582:Sick Leave; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
Calidad de vida; Chronic pain; Degenerative lumbar disease; Disability; Discapacidad; Dolor crónico; Epidemiological factors; Factores epidemiológicos; Patología lumbar degenerativa; Quality of life