Improvement in physical function and reduced pain after instrumented lumbar interbody fusion

INTRODUCTION: Instrumented lumbar fusion has been used as surgical treatment for severe disability with associated low back pain. The overall effect and risks of the most commonly used instrumented lumbar fusion techniques are controversial. The objective of the study was to describe clinical and patient-reported outcomes in patients undergoing single-level instrumented interbody fusion surgery with either posterior or transforaminal lumbar interbody fusion.

METHODS: This was a registry-based cohort study on patients from the national Danish surgical spine database - DaneSpine. The primary outcome was Oswestry Disability Index (ODI) score at two-year follow-up. Secondary outcome measures were the 3-Level European Quality of Life-5 Dimensions (EQ5D-3L), a visual analogue scale (VAS) score, patient satisfaction and the rate of intraoperative complications.

RESULTS: The cohort included 460 patients. ODI improved from 48 ± 15 preoperatively to 33 ± 20 at the two-year follow-up (p less-than 0.001). The EQ5D-3L score improved from 0.279 ± 0.311 to 0.542 ± 0.340, the VAS score for leg pain from 60 ± 28 to 40 ± 32 and back pain from 70 ± 20 to 47 ± 30. Patient satisfaction was obtained in 58%; 24% were undecided, whereas 18% were not satisfied with the treatment outcome at their two-year follow-up.

CONCLUSIONS: Patients suffering from severe back-related disability after failed conservative treatment may expect an improvement in physical function and reduced pain after instrumented lumbar interbody fusion.

FUNDING: None.

TRIAL REGISTRATION: The national Danish DaneSpine registration.