This article is more than 5 years old. Information may no longer be current.
Spine Tango findings cite predictive factors of physician-based outcomes after posterior lumbar fusion
Click Here to Manage Email Alerts
GENEVA — The number of previous spine surgeries a patient has, as well as how soon he or she sees the physician for follow-up, are the two most important predictors of physician-based outcomes in posterior lumbar fusion, according to the most recent findings of the European Spine Tango registry.
In particular, patients who have undergone four spine surgeries are more likely to have poor outcomes than good outcomes, said Markus Melloh, MD, who presented the findings at Spine Week 2008, here.
These are the first results targeting outcome evaluation with a focus on posterior lumbar fusion since the European-wide Spine Tango spine registry began 5 years ago, he said.
The investigators used prospective, consecutive hospital-based documentation for their data.
Between May 2005 and October 2007, the researchers treated 720 patients with posterior lumbar fusion for degenerative disease or spondylolisthesis. The median patient age was 63 years with a female-to-male ratio of 6.3-to-3.7.
The researchers dichotomized the original McNab criteria, combining “excellent” with “good” results to form “good,” and combining “fair” and “poor” results to form a “poor” group. They also performed multivariate logistic regression on the following potential predictor variables: age, gender, main pathology, number of previous spinal surgeries, number of spinal segments of posterior fusion, operation time, surgeon credentials and follow-up interval.
The number of previous spinal surgeries and the follow-up interval were found to be predictors of the dichotomized McNab criteria. Patients who never had spinal surgery showed the highest ratio of good-to-poor outcomes (81.4%-to-18.2%, respectively) after posterior lumbar fusion, he said.
“This ratio almost consistently decreased as the number of previous spinal surgeries increased,” Melloh said. For example, patients who had five previous surgeries had a good-to-poor outcome ratio of 40%-to-60%.
Also, at 6-week follow-up, outcomes were significantly better than after 1 year, without significant differences between other follow-up intervals.
“At 6 weeks follow-up, physicians should be aware that their outcome assessment may be too positive and should carefully monitor the outcome in later follow-up intervals,” the researchers said in their abstract.
Other examined covariables showed no influence on the outcomes, according to their abstract.
For more information:
- Melloh M, Aghayev E, Staub L, et al. Predictive factors of physician-based outcomes after posterior lumbar fusion in the Spine Tango registry. Paper AB37. Presented at Spine Week 2008. May 26-31, 2008. Geneva.