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Outcome of Spinal Fusion for Lumbar Degenerative Disease: A Cross-Sectional Study in Korea

Kong, Chang-Bae MD*; Jeon, Do-Whan MD*; Chang, Bong-Soon MD*; Lee, Jae Hyup MD*; Suk, Kyung-Soo MD†; Park, Jong-Beom MD‡

doi: 10.1097/BRS.0b013e3181c49fd0
Health Services Research

Study Design. Retrospective cross-sectional study.

Objective. To evaluate the degree of postoperative pain and patients' satisfaction after lumbar fusion from a nationwide survey in Korea.

Summary of Background Data. There have been few studies that investigated the factors related to patients' satisfaction after spinal fusion in lumbar degenerative disease (LDD).

Methods. This study included 629 patients who underwent spinal fusion for LDD at clinics of designated members of the Korean Society of Spine Surgery. This survey was done in 123 hospitals with 171 spine surgeons. Questionnaires for patients included severity of present back pain and radicular pain (visual analog scale score), Oswestry Disability Index (ODI), and subjective outcomes. Questionnaire for surgeons included preoperative diagnosis, level of fusion, operative method, and presumed patient's pain.

Results. The patients were 199 men and 430 women, with mean age of 62.3 years. The mean visual analog scale score of back pain and radicular pain was 5.0 ± 2.6 and 4.4 ± 3.0, respectively. The mean ODI was 44.3 ± 19.4. ODI was significantly increased with older age, workers' compensation, and increased fusion extent. Correlated factors of dissatisfaction were severe back pain, higher ODI, multiple operation, and insufficient explanation about postoperative pain. There was a significant correlation between preoperative explanation about postoperative pain and degree of patient's pain.

Conclusion. Patients' satisfaction was not as high as expected after fusion for LDD. Therefore, the decision for performing a lumbar fusion in those patients must be done more carefully, and it should be explained more precisely that chronic pain may persist after spinal surgery.

A retrospective cross-sectional study of 629 patients who underwent spinal fusion revealed that patients' satisfaction was not as high as expected after fusion for lumbar degenerative disease. Decision for performing a lumbar fusion in those patients must be done more carefully.

From the *Department of Orthopaedic Surgery, Seoul National University, Seoul, Republic of Korea; †Department of Orthopedic Surgery, College of Medicine, Kyung Hee University, Seoul, Republic of Korea; and ‡Department of Orthopedic Surgery, Uijongbu St. Mary's Hospital, The Catholic University of Korea, Uijongbu, Republic of Korea.

Acknowledgment date: July 14, 2009. Revision date: September 1, 2009. Acceptance date: September 1, 2009.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprint requests to Bong-Soon Chang, MD, Department of Orthopaedic Surgery, Seoul National University College of Medicine, 101 Daehangno, Jongno-Gu, Seoul 110-744, Republic of Korea; E-mail: bschang@snu.ac.kr

© 2010 Lippincott Williams & Wilkins, Inc.