Introduction and Aims: Outcome studies in select patient groups in a research environment risk reporting findings that may not be relevant to the large percentage of patients undergoing surgery in private practice in the community. This paper reports an audit of outcomes improvement in Lumbar Fusion patients using the Modified Rowland Questionnaire (MRQ).

Method: Two hundred and sixteen patients undergoing lumbar fusion procedures, over a five-year period, completed the MRQ prior to surgery and at the routine one-year follow-up. Changes to the score were documented and analysed in relation to diagnosis, third party compensation coverage, and revision procedures. The MRQ is a validated responsive disease specific functional questionnaire. It ranges from 23 points (maximum disability) to zero (no disability). A four-point improvement is considered clinically significant.

Results: Data completion was 88%. Median disability improvement was 10 points on the MRQ (p< 0.0001). Benefit occurred in 80% of patients. Although improvements in degenerative spondylolisthesis and isthmic spondylolisthesis were greater than in fusions for discogenic back pain, this was not significant. There was a trend to lesser functional improvements in those receiving compensation (p=0.073) and those who had undergone previous surgery (p=0.068).

Conclusion: This study reports an attempt to audit outcomes in private practice using an instrument applied pre-operatively and at one-year follow-up. The data completion was acceptable. Functional improvements were significant in all diagnositic groups. Outcomes in revision and compensation patients only showed trends to inferior results unlike many other studies.

This is to report an audit of outcomes improvement in Lumbar Fusion patients in a private practice setting using routine application of a robust functional outcomes instrument – the Modified Rowland Questionnaire (MRQ). The MRQ is a validated responsive disease specific functional questionnaire. It ranges from 23 points (maximum disability) to zero (no disability). Potential changes in score are 46 points (−23 to 23). A 4 point improvement is clinically significant.

Two hundred and sixteen patients undergoing lumbar fusion procedures, over a five year period completed an MRQ prior to surgery and at the routine one-year follow up. Changes to the score were documented and analysed in relation to diagnosis, Accident Compensation corporation (ACC) coverage, and revision procedures.

Data completion was 88%. Median disability improvement was 10 points on the MRM questionnaire. Benefit occurred in 80.0% of patients. Improvements were more marked in degenerative spondylolisthesis and isthmic spondylolisthesis than fusions for discogenic back pain although this was not statistically significant. There was a trend to lesser functional improvements in those on ACC and those who had undergone previous surgery.

This study reports an attempt to audit outcomes in a spinal sub specialist private practice using an instrument that can be applied preoperatively and at one year follow up without undue additional work load for the patients or staff. The data completion was acceptable. Functional improvements were significant in all diagnostic groups. Outcomes in revision and ACC patients were not significantly inferior, as they have been described in similar overseas studies.

Introduction: This paper reports an audit of outcomes improvement in lumbar fusion patients in a private practice setting using routine application of a robust functional outcomes instrument – the Modified Roland Questionnaire (MRQ). The MRQ is a validated responsive disease specific functional questionnaire. It ranges from 23 points (maximum disability) to zero (no disability). Potential changes in score are 46 points (−23 to 23). A 4 point improvement is clinically significant.

Methods: 216 patients undergoing lumbar fusion procedures, over a 5 year period completed an MRQ prior to surgery and at the routine one-year follow-up. Changes to the score were documented and analysed in relation to diagnosis, ACC coverage, and revision procedures.

Results: Data completion was 88%. Median disability improvement was 10 points on the MRQ questionnaire. Benefit occurred in 80.0% of patients. Improvements were more marked in degenerative spondylolisthesis and isthmic spondylolisthesis than fusions for discogenic back pain although this was not statistically significant. There was a trend to lesser functional improvements in those on ACC and those who had undergone previous surgery.

Discussion: This study reports an attempt to audit outcomes in a spinal sub specialist private practice using an instrument that can be applied preoperatively and at one year follow up without undue additional work load for the patients or staff. The data completion was acceptable. Functional improvements were significant in all diagnostic groups. Outcomes in revision and ACC patients were not significantly inferior, as they have been described in similar overseas studies.