We examined the differences in post-operative
functional disability and patient satisfaction between 56 patients who
underwent a lumbar fusion at three or more levels for degenerative
disease (group I) and 69 patients, matched by age and gender, who
had undergone a one or two level fusion (group II). Their mean age
was 66 years (49 to 84) and the mean follow-up was 43 months (24
to 65). The mean pre-operative Oswestry Disability Index (ODI) and visual
analogue scale (VAS) for back and leg pain, and the mean post-operative
VAS were similar in both groups (p >
0.05), but post-operatively
the improvement in ODI was significantly less in group I (40.6%)
than in group II (49.5%) (p <
0.001). Of the ten ODI items, patients
in group I showed significant problems with lifting, sitting, standing,
and travelling (p <
0.05). The most significant differences in
the post-operative ODI were observed between patients who had undergone
fusion at four or more levels and those who had undergone fusion
at less than four levels (p = 0.005). The proportion of patients
who were satisfied with their operations was similar in groups I
and II (72.7% and 77.0%, respectively) (p = 0.668). The mean number
of fused levels was associated with the post-operative ODI (r =
0.266, p = 0.003), but not with the post-operative VAS or satisfaction
grade (p >
0.05). Post-operative functional disability was more
severe in those with a