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Equating Satisfaction and Results after Spine Fusion Surgery

Successful spinal fusion doesn't always mean the patient gets better. These are the results of a study from Duke University after following 56 patients with an interbody cage lumbar fusion (ICLF) for 2.6 years.

ICLF is one method to treat chronic low back pain. The surgeon uses a special X-ray machine called fluoroscopy to perform the operation. The damaged disc is removed and a special device called a cage is inserted in its place. In fact two fusion cages are put in side by side. Then the cages are filled with bits and pieces of bone.

In this study most of the patients (84 percent) had a solid fusion. Even so half were unhappy with their function and quality of life. More than one-third were worse off and totally disabled. Factors such as age at the time of surgery, use of tobacco, depression, and legal status were examined.

The authors report that tobacco use, depression, and litigation were the best predictors of poor patient outcomes. For example patients were nine times more likely to be disabled when a lawyer was involved. The odds of being disabled were 7.7 times greater when the patient was depressed.

The authors conclude results of spinal fusion using ICLF might improve with better patient selection. Patients who smoke or who are depressed before surgery could get treatment first and then have the fusion for a better final outcome.

References: Rick A. LaCaille, PhD, et al. Presurgical Biopsychosocial Factors Predict Multidimensional Patient: Outcomes of Interbody Cage Lumbar Fusion. In The Spine Journal. January/February 2005. Vol. 5. No. 1. pp. 71-78.

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