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ABSTRACT.
Objective: To examine functional status in preoperative and postoperative patients treated with instrumented fusion due to chronic low back pain.
Methods: A comparative cross-sectional survey design was applied to compare pain, disability, and work status in preoperative patients and in patients who had surgery one to eight years after surgery. Assessment tools were a visual analog scale and the Oswestry Disability Index.
Results: Twenty-five preoperative patients [mean age 45 ± 6.5 years] and 101 postoperative patients [46 ± 8.9 years] participated in the study. The postoperative patients as a group reported significantly less back and hip pain [P < 0.001], less leg pain [P < 0.001], less disability [P < 0.001], less use of analgesics [P < 0.05], and were more frequently employed [P = 0.01] than the group of preoperative patients. Most of the postoperative patients [74 percent] report using less analgesic than before the operation. However, six from the group of postoperative patients reported very severe or worst imaginable pain, and five of them were crippled or bed-bound. Patients who underwent surgery five to eight years ago tended to report less disability as compared to patients who underwent surgery one to two years ago [P < 0.03].
Conclusions: Postoperative patients as a group had substantially less pain intensity and disability one to eight years following instrumented fusion than a comparison group of preoperative patients. Although the same patients were not followed over time, disability may seem to decrease somewhat as a function of time after surgery. However, not all patients who had spinal fusion obtained a favorable result.