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LONG TERM FOLLOW-UP OF PATIENTS UNDERGOING PLIF SURGERY



Abstract

Purposes: To evaluate the effectiveness of Posterior Lumbar Interbody Fusion (PLIF) surgery in resolving back and back related leg pain and its effect on quality of life.

Methods: Two hundred and twenty six patients who met the inclusion criteria of degenerative disc disease, spondylolisthesis, disc herniation and postlaminec-tomy/postdiscectomy syndrome unresolved by conservative therapy were entered into the study. Patients were assessed using a self-administered questionnaire containing the Oswestry disability index (ODI) for back pain related disability, visual analogue scales (VAS) for back and leg pain severity (0 = none, 10 = worst imaginable pain) and the SF-36 general health questionnaire. Outcomes were assessed preoperatively and at a minimum of 2 years follow-up. Statistical significance was tested using a paired t-test after confirming normality of the data.

Results: Of the 226 patients,182 (99 females, 83 males; mean age at treatment, 45.3 years; age range 15 – 67 years) returned follow-up questionnaires (81% response). The mean duration of follow-up was 26.4 months (range 24 – 60 months). The ODI showed a statistically and clinically significant improvement between baseline (52.1) and follow-up (29.5), (22.6(17.8 to 27.5); P= 0.000). This represents a 43% improvement in functional ability. There was a statistically and clinically significant improvement between VAS back pain scores at baseline (7.7) and follow-up (3.9), (3.8 (3.1 to 4.4); P = 0.000 ). This represents a reduction of 49%. Similarly VAS leg pain at baseline (6.6) and follow-up (3.2) ,(3.4 (2.7 to 4.2); P = 0.000) showed a reduction of 52% which was also statistically and clinically significant. All dimensions of the SF-36 except role physical showed a statistically and clinically significant improvement.

Conclusion: The results show that in our series, there is a statistically and clinically significant improvement in pain, functional ability and quality of life after PLIF surgery in patients with chronic back and leg pain unresolved by conservative therapy.

Correspondence should be addressed to: Sue Woodward, Secreteriat, Britspine, Vale Clinic, Hensol Park, Vale of Glamorgan, CF72 8JY Wales.