Tags

Type your tag names separated by a space and hit enter

Circumferential fusion improves outcome in comparison with instrumented posterolateral fusion: long-term results of a randomized clinical trial.
Spine (Phila Pa 1976). 2006 Dec 01; 31(25):2875-80.S

Abstract

STUDY DESIGN

Prospective randomized clinical study with a 5- to 9-year follow-up period.

OBJECTIVE

The aim of the present study was to analyze the long-term outcome with respect to functional disability, pain, and general health of patients treated by means of circumferential lumbar fusion in comparison with those treated by means of instrumented posterolateral lumbar fusion.

SUMMARY OF BACKGROUND DATA

Circumferential fusion has become a common procedure in lumbar spinal fusion both as a primary and salvage procedure. However, the claimed advantages of circumferential fusion over conventional posterolateral fusion lack scientific documentation. (The primary report with a 2-year follow-up has been published in Spine in 2002.)

METHODS

From April 1996 to November 1999, a total of 148 patients (mean age, 45 years) with severe chronic low back pain were randomly selected for either posterolateral lumbar fusion (titanium Cotrel-Dubousset) or circumferential lumbar fusion (instrumented posterolateral fusion with anterior intervertebral support by a Brantigan cage). The primary outcome measure was the Dallas Pain Questionnaire (DPQ). The secondary outcome measures were the Oswestry Disability Index, the SF-36 instrument, and the Low Back Pain Rating Scale. All measures assessed the endpoint outcomes at 5 to 9 years after surgery.

RESULTS

The available response rate was 93%. The circumferential group showed a significantly better improvement (P < 0.05) in comparison with the posterolateral group with respect to all four DPQ categories: daily activities, work/leisure, anxiety/depression, and social interest. The Oswestry Disability Index supported these results (P < 0.01). General health, as assessed by means of the SF-36, also showed significantly better physical health (P < 0.01) in the circumferential group, whereas no significant difference was found with respect to mental health compared with the posterolateral group. The circumferential group experienced significantly less back pain (P < 0.05) in comparison with the posterolateral group. In regard to leg pain, no significant difference was found.

CONCLUSION

Circumferential lumbar fusion demands more extensive operative resources compared with posterolateral lumbar fusion. However, 5 to 9 years after surgery, the circumferentially fused patients had a significantly improved outcome compared with those treated by means of posterolateral fusion. These new results not only emphasize the superiority of circumferential fusion in the complex pathology of the lumbar spine but are also strongly supported in all of the validated questionnaires used in the study.

Links

Aggregator Full Text

Authors+Show Affiliations

Videbaek TS
Spine Unit, Department of Orthopaedics, University Hospital of Aarhus, Aarhus, Denmark.
Christensen FB
No affiliation info available
Soegaard R
No affiliation info available
Hansen ES
No affiliation info available
Høy K
No affiliation info available
Helmig P
No affiliation info available
Niedermann B
No affiliation info available
Eiskjoer SP
No affiliation info available
Bünger CE
No affiliation info available

MeSH

AdultAgedFemaleFollow-Up StudiesHumansLow Back PainLumbar VertebraeMaleMiddle AgedProspective StudiesSpinal FusionTimeTreatment Outcome

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17139217

Citation

Videbaek, Tina S., et al. "Circumferential Fusion Improves Outcome in Comparison With Instrumented Posterolateral Fusion: Long-term Results of a Randomized Clinical Trial." Spine, vol. 31, no. 25, 2006, pp. 2875-80.
Videbaek TS, Christensen FB, Soegaard R, et al. Circumferential fusion improves outcome in comparison with instrumented posterolateral fusion: long-term results of a randomized clinical trial. Spine (Phila Pa 1976). 2006;31(25):2875-80.
Videbaek, T. S., Christensen, F. B., Soegaard, R., Hansen, E. S., Høy, K., Helmig, P., Niedermann, B., Eiskjoer, S. P., & Bünger, C. E. (2006). Circumferential fusion improves outcome in comparison with instrumented posterolateral fusion: long-term results of a randomized clinical trial. Spine, 31(25), 2875-80.
Videbaek TS, et al. Circumferential Fusion Improves Outcome in Comparison With Instrumented Posterolateral Fusion: Long-term Results of a Randomized Clinical Trial. Spine (Phila Pa 1976). 2006 Dec 1;31(25):2875-80. PubMed PMID: 17139217.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Circumferential fusion improves outcome in comparison with instrumented posterolateral fusion: long-term results of a randomized clinical trial. AU - Videbaek,Tina S, AU - Christensen,Finn B, AU - Soegaard,Rikke, AU - Hansen,Ebbe S, AU - Høy,Kristian, AU - Helmig,Peter, AU - Niedermann,Bent, AU - Eiskjoer,Søren P, AU - Bünger,Cody E, PY - 2006/12/2/pubmed PY - 2007/1/6/medline PY - 2006/12/2/entrez SP - 2875 EP - 80 JF - Spine JO - Spine (Phila Pa 1976) VL - 31 IS - 25 N2 - STUDY DESIGN: Prospective randomized clinical study with a 5- to 9-year follow-up period. OBJECTIVE: The aim of the present study was to analyze the long-term outcome with respect to functional disability, pain, and general health of patients treated by means of circumferential lumbar fusion in comparison with those treated by means of instrumented posterolateral lumbar fusion. SUMMARY OF BACKGROUND DATA: Circumferential fusion has become a common procedure in lumbar spinal fusion both as a primary and salvage procedure. However, the claimed advantages of circumferential fusion over conventional posterolateral fusion lack scientific documentation. (The primary report with a 2-year follow-up has been published in Spine in 2002.) METHODS: From April 1996 to November 1999, a total of 148 patients (mean age, 45 years) with severe chronic low back pain were randomly selected for either posterolateral lumbar fusion (titanium Cotrel-Dubousset) or circumferential lumbar fusion (instrumented posterolateral fusion with anterior intervertebral support by a Brantigan cage). The primary outcome measure was the Dallas Pain Questionnaire (DPQ). The secondary outcome measures were the Oswestry Disability Index, the SF-36 instrument, and the Low Back Pain Rating Scale. All measures assessed the endpoint outcomes at 5 to 9 years after surgery. RESULTS: The available response rate was 93%. The circumferential group showed a significantly better improvement (P < 0.05) in comparison with the posterolateral group with respect to all four DPQ categories: daily activities, work/leisure, anxiety/depression, and social interest. The Oswestry Disability Index supported these results (P < 0.01). General health, as assessed by means of the SF-36, also showed significantly better physical health (P < 0.01) in the circumferential group, whereas no significant difference was found with respect to mental health compared with the posterolateral group. The circumferential group experienced significantly less back pain (P < 0.05) in comparison with the posterolateral group. In regard to leg pain, no significant difference was found. CONCLUSION: Circumferential lumbar fusion demands more extensive operative resources compared with posterolateral lumbar fusion. However, 5 to 9 years after surgery, the circumferentially fused patients had a significantly improved outcome compared with those treated by means of posterolateral fusion. These new results not only emphasize the superiority of circumferential fusion in the complex pathology of the lumbar spine but are also strongly supported in all of the validated questionnaires used in the study. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/17139217/Circumferential_fusion_improves_outcome_in_comparison_with_instrumented_posterolateral_fusion:_long_term_results_of_a_randomized_clinical_trial_ L2 - https://doi.org/10.1097/01.brs.0000247793.99827.b7 DB - PRIME DP - Unbound Medicine ER -