Abstract
Introduction
An important number of factors affecting the outcome of surgical treatment have been identified, and these factors can affect the patient's selection for lumbar surgery.
Study Design
Retrospective study with data collected prospectively on patients undergoing surgery for degenerative lumbar pathology (DLP).
Purpose
Identification and evaluation of epidemiological factors that influence the quality of life improvement, disability and chronic pain.
Outcome measures
Visual Analogue Scale (VAS) to assess pain in lower back and extremities, Short Form-36v2 (SF-36), Oswestry Disability Index (ODI) and Core Outcome Measures Index (COMI).
Method
263 patients were included in our study, with a mean age of 54.0 years (22–86 years). 131 patients were women (49.8%). Questionnaires were completed in the preoperative visit and 2 years after surgery. Epidemiological data collected were age, sex, educational level, employment status, diagnosis, treatment, and comorbidity measure by ASA. The most frequent diagnostics were degenerative discal disease (36,5%) and lumbar stenosis (30,4%) and a main surgical treatment was TLIF (31,9 %). To compare means we used t-Student and Pearson's coefficient or Spearman's test was used to assess the correlation, and, finally, linear regression study (ANOVA) was performed with variables that showed statistically significant correlation. SPSS 15.0 statistical package.
Results
Sex and employment status was correlated with the improvement of COMI (r=− 0.257, p <0.05, r=0.272, p <0.05). Employment status was correlated with in ODI (r=0.249, p <0.05) and the degree of improvement physical component of SF-36 (PCS, r=− 0.254, p <0.05).
Linear regression showed statistically significant influence of the age (r=0.334, p <0.05) and employment status (r=14.146, p <0.01) on ODI. COMI is statistically influenced by sex (r=− 0.869, p <0.01), age (r=0.027, p <0.05) and employment status (r=0.830, p <0.05). PCS is statistically influenced by the employment status (r=− 8.568, p <0.01), age (r=− 0.228, p <0.05) and sex (r=5.525, p <0.05).
Conclusions
According to the present study we observed that the perception of change in the quality of life and disability after surgery of the lumbar spine is independent of the initial pathology, the type of surgery and previous pain and disability; but sex, age and employment status have an important influence.
