Toivonen Leevi, Pekkanen Liisa, Neva Marko H, Kautiainen Hannu, Kyrölä Kati, Marttinen Ilkka, Häkkinen Arja
Department of Orthopedics and Traumatology, Tampere University Hospital, Tampere, Finland.
Department of Orthopedics and Traumatology, Central Finland Health Care District, Jyväskylä, Finland.
Global Spine J. 2022 Jul;12(6):1052-1057. doi: 10.1177/2192568220972977. Epub 2020 Nov 18.
Prospective follow-up study.
We aimed to assess the effect of lumbar spine fusion (LSF) on disability, health-related quality of life and mortality in a 5-year follow-up, and to compare these results with the general population.
523 consecutive LSF operations were included in a prospective follow-up. Disability was assessed by the Oswestry Disability Index (ODI), and HRQoL by the 36-item Short Form (SF-36) questionnaire using the physical and mental summary scores (PCS and MCS). The patients were compared with an age-, sex-, and residential area matched general population cohort.
The preoperative ODI in the patients was 46 (SD 16), and the change at 5 years was -26 (95% CI: -24 to -28), p < 0.001. In the population, ODI (baseline 13, SD 16) remained unchanged. The preoperative PCS in the patients was 27 (SD 7), in the population 45 (SD 11), and the increase in the patients at 5 years was 8 (95% CI: 7 to 9), p < 0.001. The patients did not reach the population in ODI or PCS. The baseline MCS in the patients was 47 (SD 13), and the change at 5 years 4 (95% CI: 3 to 7), p < 0.001. MCS of the females reached the population at 5-year follow-up. When analyzing short and long fusions separately, comparable changes were seen in both subgroups. There was no difference in mortality between the patients (3.4%) and the population (4.8%), hazard ratio (HR) 0.86.
Although the patients who had undergone LSF benefited from surgery still at 5 years, they never reached the physical level of the population.
前瞻性随访研究。
我们旨在评估腰椎融合术（LSF）在5年随访中对残疾、健康相关生活质量和死亡率的影响，并将这些结果与普通人群进行比较。
523例连续的LSF手术被纳入前瞻性随访。通过奥斯威斯利残疾指数（ODI）评估残疾情况，通过36项简短形式（SF-36）问卷使用身体和心理总结得分（PCS和MCS）评估健康相关生活质量。将患者与年龄、性别和居住地区匹配的普通人群队列进行比较。
患者术前ODI为46（标准差16），5年时的变化为-26（95%置信区间：-24至-28），p<0.001。在普通人群中，ODI（基线13，标准差16）保持不变。患者术前PCS为27（标准差7），普通人群为45（标准差11），患者5年时的增加为8（95%置信区间：7至9），p<0.001。患者在ODI或PCS方面未达到普通人群水平。患者基线MCS为47（标准差13），5年时的变化为4（95%置信区间：3至7），p<0.001。女性的MCS在5年随访时达到普通人群水平。分别分析短融合和长融合时，两个亚组均观察到类似变化。患者（3.4%）和普通人群（4.8%）的死亡率无差异，风险比（HR）为0.86。
尽管接受LSF手术的患者在5年时仍从手术中获益，但他们从未达到普通人群的身体水平。
