Health-related quality of life: a comparison of outcomes after lumbar fusion for degenerative spondylolisthesis with large joint replacement surgery and population norms
Journal Articles
Overview
Research
Identity
Additional Document Info
View All
Overview
abstract
BACKGROUND CONTEXT: Degenerative spine disease will become an increasing health problem, and a significant number of patients will be considered for surgery. Spinal surgeries have evolved since the last decades, and there is a positive impact on the clinical outcomes. Few works in the literature have reviewed the outcome compared with large joint replacement surgery, which is considered a benchmark for operative restoration of patients' quality of life. PURPOSE: The purpose of this study was to investigate if spinal fusion can return patients' health-related quality of life to that of age-matched population norms and yield outcomes comparable with those of total hip and knee joint replacement. STUDY DESIGN: This is a prospective cohort study. PATIENT SAMPLE: The sample consists of 100 consecutive patients who were enrolled between December 1997 and January 2007. OUTCOME MEASURES: The 12-item Short Form Health Survey (SF-12) was chosen for outcome measurement. METHODS: All patients underwent wide decompressive laminectomy and single-level posterior lumbar interbody fusion for spinal stenosis associated with degenerative spondylolisthesis. RESULTS: The preoperative and postoperative physical component summary (PCS)-12 scores of the spinal fusion patients were comparable with those of both the total knee and hip replacement patients. The mean improvement in PCS-12 scores after spine surgery was 11 (95% confidence interval [CI]: 9-14, p<.0001). It was equal to that after total hip replacement surgery, which was 11 (95% CI: 9-13), and higher than that of total knee replacement patients, which had an improvement of 8 (95% CI: 7-9). The postoperative mean and 95% CI of the PCS-12 scores for the three surgical procedures approached the population norm value of 44 (95% CI: 43-46).There was no statistical difference between the postoperative mental component summary-12 score among all the three surgical groups, which approached similar to the population norm value of 54 (95% CI: 53-54). CONCLUSIONS: The current study demonstrated that spinal surgery can return patients' HRQL to that of age-matched population norms and yield outcomes comparable with those of total hip and knee joint replacement patients.
