Abstract
Statement of Purposes
Functional Restoration (FR) and spinal fusion are both used as treatment for patients with chronic low back pain however opinions are divided over their long term efficacy. This study examines the 18 month to 8 year outcomes of stand-alone lumbar fusion (STALIF) at L5/S1 and FR in similar groups of patients.
Methods
A prospective audit was undertaken using data routinely collected from the practice of the senior author. Pain (VAS), disability (ODI) and patients' subjective appraisals were used as comparable outcome measures. SPSS was used for statistical analysis.
Results
STALIF patients had sustained significant improvements in their VAS and ODI scores at study end, compared to the pre-operative assessments.
FR patients demonstrated significant improvements in their VAS scores and measurable functionality on discharge from the programme, but these deteriorated by the one-month follow-up. At study end there was a significant deterioration in the outcomes compared to discharge.
Patient perceived success was 85% in the STALIF patients and 58% in the FR. 24% of FR patients subsequently required surgery.
Conclusions
Both groups demonstrated statistically significant improvements in pain and disability/functionality scores during the period of the study however improvements in the FR groups occurred only during the active phase and significantly reduced by study end. The low patient satisfaction rating for the FR group and the need for 25% to subsequently undergo surgery indicates that further robust investigation to clarify “real” sustainability and rule out short-term benefits that arise from psychological cushioning or simply a training effect is required.
Conflicts of Interest
None
Source of Funding
None
This abstract has not been previously published in whole or substantial part nor has it been presented at a national meeting.
