Tags

Type your tag names separated by a space and hit enter

Long-term outcomes of revision fusion for lumbar pseudarthrosis: clinical article.
J Neurosurg Spine. 2011 Oct; 15(4):393-8.JN

Abstract

OBJECT

The number of low-back fusion procedures for the treatment of spine disorders has increased steadily over the past 10 years. Lumbar pseudarthrosis is a potential complication of lumbar arthrodesis and can be associated with significant pain and disability. The aim of this study was to assess, using validated patient-reported outcomes measures, the long-term effectiveness of revision arthrodesis in the treatment of symptomatic pseudarthrosis.

METHODS

This is a retrospective study of 47 patients who underwent revision lumbar arthrodesis for pseudarthrosis-associated back pain. Baseline 2-year outcomes were assessed using the following: visual analog scale (VAS) for back pain, Oswestry Disability Index (ODI), Zung Self-Rating Depression Scale, time to narcotic independence, time to return to work, EuroQol health-state utility, and physical and mental quality of life (Short Form [SF]-12 Physical and Mental Component Summary scores).

RESULTS

The mean duration of time between prior fusion and development of symptomatic pseudarthrosis was 2.69 years. Bone morphogenetic protein was used in 4 cases (8.5%) of revision arthrodesis. A significant improvement in VAS back pain (7.31 ± 0.81 vs 5.06 ± 2.64, p = 0.001), ODI (29.74 ± 5.35 vs 25.42 ± 6.0, p = 0.001), and physical health SF-12 (23.83 ± 6.89 vs 27.85 ± 8.90, p = 0.001) scores was observed when comparing baseline and 2-year post-revision arthrodesis scores, respectively, with a mean cumulative 2-year gain of 0.35 quality-adjusted life years. The median time to narcotics independence was 12.16 (interquartile range 1.5-24.0) months and the median time to return to work was 4 months (interquartile range 3-5 months). By 2 years after revision surgery, no patients had experienced pseudarthrosis. The SF-12 Mental Component Summary (44.72 ± 7.90 vs 43.46 ± 7.51, p = 0.43) and Zung Self-Rating Depression Scale scores (39.36 ± 7.48 vs 41.39 ± 10.72, p = 0.37) were not significantly improved by 2 years.

CONCLUSIONS

The authors' study suggests that revision lumbar arthrodesis for symptomatic pseudarthrosis provides improvement in low-back pain, disability, and quality of life. Revision lumbar arthrodesis should be considered a viable treatment option for patients with pseudarthrosis-related back pain. Mental health symptoms from pseudarthrosis-associated back pain may be more refractory to revision surgery.

Authors+Show Affiliations

Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21699473

Citation

Adogwa, Owoicho, et al. "Long-term Outcomes of Revision Fusion for Lumbar Pseudarthrosis: Clinical Article." Journal of Neurosurgery. Spine, vol. 15, no. 4, 2011, pp. 393-8.
Adogwa O, Parker SL, Shau D, et al. Long-term outcomes of revision fusion for lumbar pseudarthrosis: clinical article. J Neurosurg Spine. 2011;15(4):393-8.
Adogwa, O., Parker, S. L., Shau, D., Mendelhall, S. K., Cheng, J., Aaronson, O., Devin, C. J., & McGirt, M. J. (2011). Long-term outcomes of revision fusion for lumbar pseudarthrosis: clinical article. Journal of Neurosurgery. Spine, 15(4), 393-8. https://doi.org/10.3171/2011.4.SPINE10822
Adogwa O, et al. Long-term Outcomes of Revision Fusion for Lumbar Pseudarthrosis: Clinical Article. J Neurosurg Spine. 2011;15(4):393-8. PubMed PMID: 21699473.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term outcomes of revision fusion for lumbar pseudarthrosis: clinical article. AU - Adogwa,Owoicho, AU - Parker,Scott L, AU - Shau,David, AU - Mendelhall,Stephen K, AU - Cheng,Joseph, AU - Aaronson,Oran, AU - Devin,Clinton J, AU - McGirt,Matthew J, Y1 - 2011/06/24/ PY - 2011/6/25/entrez PY - 2011/6/28/pubmed PY - 2011/12/13/medline SP - 393 EP - 8 JF - Journal of neurosurgery. Spine JO - J Neurosurg Spine VL - 15 IS - 4 N2 - OBJECT: The number of low-back fusion procedures for the treatment of spine disorders has increased steadily over the past 10 years. Lumbar pseudarthrosis is a potential complication of lumbar arthrodesis and can be associated with significant pain and disability. The aim of this study was to assess, using validated patient-reported outcomes measures, the long-term effectiveness of revision arthrodesis in the treatment of symptomatic pseudarthrosis. METHODS: This is a retrospective study of 47 patients who underwent revision lumbar arthrodesis for pseudarthrosis-associated back pain. Baseline 2-year outcomes were assessed using the following: visual analog scale (VAS) for back pain, Oswestry Disability Index (ODI), Zung Self-Rating Depression Scale, time to narcotic independence, time to return to work, EuroQol health-state utility, and physical and mental quality of life (Short Form [SF]-12 Physical and Mental Component Summary scores). RESULTS: The mean duration of time between prior fusion and development of symptomatic pseudarthrosis was 2.69 years. Bone morphogenetic protein was used in 4 cases (8.5%) of revision arthrodesis. A significant improvement in VAS back pain (7.31 ± 0.81 vs 5.06 ± 2.64, p = 0.001), ODI (29.74 ± 5.35 vs 25.42 ± 6.0, p = 0.001), and physical health SF-12 (23.83 ± 6.89 vs 27.85 ± 8.90, p = 0.001) scores was observed when comparing baseline and 2-year post-revision arthrodesis scores, respectively, with a mean cumulative 2-year gain of 0.35 quality-adjusted life years. The median time to narcotics independence was 12.16 (interquartile range 1.5-24.0) months and the median time to return to work was 4 months (interquartile range 3-5 months). By 2 years after revision surgery, no patients had experienced pseudarthrosis. The SF-12 Mental Component Summary (44.72 ± 7.90 vs 43.46 ± 7.51, p = 0.43) and Zung Self-Rating Depression Scale scores (39.36 ± 7.48 vs 41.39 ± 10.72, p = 0.37) were not significantly improved by 2 years. CONCLUSIONS: The authors' study suggests that revision lumbar arthrodesis for symptomatic pseudarthrosis provides improvement in low-back pain, disability, and quality of life. Revision lumbar arthrodesis should be considered a viable treatment option for patients with pseudarthrosis-related back pain. Mental health symptoms from pseudarthrosis-associated back pain may be more refractory to revision surgery. SN - 1547-5646 UR - https://www.unboundmedicine.com/medline/citation/21699473/Long_term_outcomes_of_revision_fusion_for_lumbar_pseudarthrosis:_clinical_article_ L2 - https://thejns.org/doi/10.3171/2011.4.SPINE10822 DB - PRIME DP - Unbound Medicine ER -