Kuopio Musculoskeletal Research Unit (KMRU), Institute of Clinical Medicine, School of Medicine, University of Eastern Finland (UEF), Kuopio.
Department of Orthopedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland.
Acta Orthop. 2023 Jan 25;94:19-25. doi: 10.2340/17453674.2023.7129.
Studies investigating the effect of spinal surgery on both physical capability (PC) and subjective well-being (SW) are scarce. We aimed to investigate self-reported PC and SW up to 20 years after lumbar spine surgery.
6,612 postmenopausal Finnish women (47-56 years at baseline [BL]), from the Osteoporosis Risk Factor and Prevention (OSTPRE) study, were followed-up (FU) for 20 years. The Finnish Care Register for Healthcare (CRFH) provided data on surgery in the OSTPRE population on lumbar spinal stenosis (LSS) and lumbar disc herniation (LDH). PC and SW of women with lumbar surgery was compared with that of women without lumbar surgery. A chi-square analysis was conducted to analyze the statistical differences in the distribution of PC and SW. A propensity score-matched control analysis was also performed in addition to analysis of the total populationbased control group.
In women without lumbar surgery 94% reported good PC at BL, which decreased to 79% at the 20-year FU. For those with LSS/LDH surgery, 84%/(37/50) reported good PC at BL and 80%/(33/50) at 20-year FU, respectively. Good SW was reported by 48% of the control group at BL, 50% at 10-year FU, and 42% at 20-year FU. Women with LSS/LDH surgery before the 10-year FU reported good SW as follows: (6/50)/38% at BL, (12/48)/39% at 10-year FU, and (9/50)/37% at 20-year FU.
Patients with LSS and LDH report lower PC and SW. Lumbar spinal surgery improves PC and SW in the short term, with early LDH surgery showing the greatest benefits whereas late surgery did not. Overall, PC and SW are lower both initially and during the 20-year FU when compared with the age-matched controls except for early LDH surgery.
研究脊柱手术后对身体能力（PC）和主观幸福感（SW）的影响的研究很少。我们旨在调查腰椎手术后 20 年内自我报告的 PC 和 SW。
来自骨质疏松症风险因素和预防（OSTPRE）研究的 6612 名绝经后芬兰女性（基线时 47-56 岁）进行了 20 年的随访（FU）。芬兰医疗保健登记处（CRFH）提供了 OSTPRE 人群中腰椎椎管狭窄症（LSS）和腰椎间盘突出症（LDH）手术的数据。比较了有腰椎手术和无腰椎手术的女性的 PC 和 SW。使用卡方分析比较了 PC 和 SW 的分布的统计学差异。除了基于总人群的对照组分析外，还进行了倾向评分匹配的对照组分析。
在没有腰椎手术的女性中，94%在 BL 时报告 PC 良好，而在 20 年 FU 时降至 79%。对于 LSS/LDH 手术的女性，84%/（37/50）在 BL 时报告 PC 良好，80%/（33/50）在 20 年 FU 时报告 PC 良好。对照组 48%在 BL 时报告 SW 良好，50%在 10 年 FU 时报告 SW 良好，42%在 20 年 FU 时报告 SW 良好。在 10 年 FU 之前接受 LSS/LDH 手术的女性报告如下：（6/50）/38%在 BL 时，（12/48）/39%在 10 年 FU 时，（9/50）/37%在 20 年 FU 时。
LSS 和 LDH 的患者报告 PC 和 SW 较低。腰椎手术可在短期内改善 PC 和 SW，早期 LDH 手术效果最佳，而晚期手术则没有效果。与年龄匹配的对照组相比，无论是否进行早期 LDH 手术，初始和 20 年 FU 期间的 PC 和 SW 均较低。
