Study Design: Prospective, clinical study.
Objective: This study compares the preoperative and postoperative status of patients with degenerative lumbar spine disorders, who underwent instrumented posterior lumbar fusion (IPLF), from the functional, economic and psychologic perspectives in a semirural population.
Summary of Background Data: IPLF is a common procedure in the treatment of a more common disorder, lumbar spine degeneration. It has been postulated that both the disorder and the surgical procedure may affect many aspects of patients' life.
Methods: During a 2 years period, 46 patients underwent IPLF for degenerative disorders of the lumbar spine. The surgical procedure included posterior decompression of the affected segment(s) and stabilization by means of pedicle screws and rods in every case, and interbody implants in selected cases. The outcome measures included the Greek versions of (a) Visual Analogue Scale (VAS) for pain assessment, (b) Oswestry Disability Index (ODI) for back-related disability, (c) Prolo Scale for the functional and economic status and (d) Zung Depression Scale to screen for depression. Measurements were taken 1-week preoperatively, and 3 years after the procedure. The comparison of the preoperative and postoperative results was done using the paired-samples t test.
Results: Thirty-nine patients (25 females, 14 males) with a mean age of 59 years were eligible for our study. Half of them worked in the agricultural sector. All developed solid, lumbar fusions. Instrumented posterior lumbar fusion decreased patient's somatic pain, as shown by the VAS (P<0.001) and improved function as indicated by the ODI (P<0.001), and allowed return to work (P<0.001). Nevertheless, the Zung Depression Scale revealed that the incidence of depression increased postoperatively (P<0.001).
Conclusions: IPLF in the treatment of degenerative disorders of the lumbar spine improves function and promotes the patients' complete or partial return to work. In contrast, degenerative lumbar spine disorders are chronic conditions and may negatively affect patients' psychology.