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Surgical technique shows no impact on short-term outcomes in patients undergoing fusion for lower back pain

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SAN DIEGO — Operative technique does not have a significant impact on outcomes for patients undergoing fusion for lower back pain at a 2 years, according to the results of a study presented here.

Yohan Robinson, MD, shared his findings at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons.

Though the findings support those of published studies regarding the positive impact of surgery on function, pain, and quality of life in patients with chronic lower back pain, Robinson said his group considered it “interesting” that their study cohort displayed no significant changes in outcome dependent upon fusion technique.

Yohan Robinson

Robinson’s group used the Swedish National Spine Register to follow up 1,310 patients with chronic lower back pain who underwent spinal fusion. The Oswestry Disability Index (ODI) for function, visual analog Scale score (VAS) for leg and back pain, and Euroquol-5D (EQ-5D) measures were entered preoperatively and at a 2-year follow-up.

The investigators analyzed results for 115 patients operated on with uninstrumented fusion (UIF), 620 patients treated with instrumented posterolateral fusion (IPF) and 575 patients treated with posterior interbody fusion (PLIF).

The EQ-5D, ODI, and VAS scores improved in all groups, and a comparison of the groups revealed no significant differences regarding these scores. Robinson did note, however, that there was a slightly greater improvement of VAS score in the PLIF group when compared to the UIF group.

“This study did not give any evidence that there is any one method of fusion superior to the other,” Robinson said. “But, I think we can all agree we should wisely choose fusion methods that are the least harmful — and those in which we feel the most confident.”

Reference:

• Robinson Y, et al. Improved outcome after fusion for chronic low back pain is not dependent on operation technique. Paper 264. Presented at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons. Feb. 14-19, 2011. San Diego.

Disclosure: Robinson receives financial support from DePuy and Synthes.

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