Anterior lumbar fusion: Results, assessment techniques and prognostic factors

Abstract

One hundred and fifty-one patients underwent anterior interbody lumbar spinal fusion for intractable back pain. A solid bony fusion was obtained in 76%. The method of outcome assessment profoundly affected the results; whereas 68% of patients rated themselves as significantly improved by the procedure, only 40% achieved a good or excellent result on the more objective low-back outcome score. Patients who underwent a second procedure did not do well, and "salvage" surgery is not recommended. Posterior distraction instrumentation neither increased the rate of union nor improved the final results. The rate of fusion was influenced by the presence of a compensation claim. Compensation status and psychological disturbance at presentation were significant prognostic factors. Psychological disturbance at review had a profound effect on the outcome and patient satisfaction ratings. It is recommended that future studies employ a recognised outcome score and that the analysis specifically includes compensation status and psychological disturbance.

Pain 5 years after instrumented and non-instrumented posterolateral lumbar spinal fusion

“…Pain drawings have been used in spinal surgery for psychological evaluation of patients [8,18,32,40], for diagnostic purposes [5,29,30,31,33] and for prediction of outcome [15,23,24,37]. Few have used the pain drawing for evaluation of pain after spinal surgery.…”

Retrograde ejaculation after retroperitoneal lower lumbar interbody fusion

“…The first results of anterior lumbar interbody fusion were described in 1932 [2], and since then there have been many reports of the technique, results and complications [6,10,14,15,20,21]. Male genital dysfunction was recognised as a complication in the 60s and 70s [4,7,13,16], and an incidence of up to 20% has been reported using the transperitoneal approach [19].…”

Evolução psicossomática e clínica de pacientes com estenose do canal lombar operados com sistema interespinhoso

“…However, if the ZDS improvement was obtained with statistical significance, that was not confirmed with the MSPQ, where improvement was not obtained, becoming, on the other hand, an indicator of prior emotional stability that remained unchanged throughout the study, reinforcing our research interest. 32,33,82 In summary, we obtained a clear clinical and functional improvement of our patients that was maintained throughout the two years of assessment and was significantly accompanied by the rate of depression (ZDS), while the MSPQ remained within the normal range, while showing no significant improvement after surgery.…”