دورية أكاديمية

Repair of a pseudarthrosis of the lumbar spine. A functional outcome study.

التفاصيل البيبلوغرافية
العنوان: Repair of a pseudarthrosis of the lumbar spine. A functional outcome study.
المؤلفون: Carpenter CT; Swedish Hospital, Seattle, Washington, USA., Dietz JW, Leung KY, Hanscom DA, Wagner TA
المصدر: The Journal of bone and joint surgery. American volume [J Bone Joint Surg Am] 1996 May; Vol. 78 (5), pp. 712-20.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Journal of Bone and Joint Surgery Country of Publication: United States NLM ID: 0014030 Publication Model: Print Cited Medium: Print ISSN: 0021-9355 (Print) Linking ISSN: 00219355 NLM ISO Abbreviation: J Bone Joint Surg Am Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Boston, MA : Journal of Bone and Joint Surgery
مواضيع طبية MeSH: Lumbar Vertebrae/*injuries , Pseudarthrosis/*surgery , Spinal Fractures/*surgery, Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Pseudarthrosis/diagnostic imaging ; Radiography ; Retrospective Studies ; Smoking ; Spinal Fractures/diagnostic imaging ; Spinal Fusion ; Treatment Outcome ; Workers' Compensation
مستخلص: Eighty-six patients had a total of eighty-eight primary attempts at repair of a pseudarthrosis that had developed after a localized arthrodesis in the lumbar spine. A follow-up questionnaire was sent to all patients at a mean of fifty-one months (range, twenty-five to seventy-eight months) after the operation; seventy-two patients (84 percent) completed to questionnaire. A solid fusion was ultimately achieved after the treatment of eighty-one (94 percent) of the eighty-six pseudarthroses for which radiographic data were available. With the numbers available, we could find no significant association between a solid fusion and the patient's age, gender, body-mass index, return to work, or outcome score. Despite the high rate of fusion after the index repair and subsequent procedures, only nineteen (26 percent) of the seventy-two patients who completed the questionnaire eventually had a good or excellent outcome. Seven (10 percent) had an excellent result (90 to 100 points), twelve (17 percent) had a good result (70 to 89 points), fourteen (19 percent) had a fair result (50 to 69 points), and thirty-nine (54 percent) had a poor result (less than 50 points). Nevertheless, fifty-one patients (71 percent) reported that the operation led to some improvement, and fifty-five (76 percent) said that they would have the operation again if the circumstances were similar to those before the repair of the pseudarthrosis. Thirty-four of the seventy-two patients were smokers and thirty-eight were non-smokers at the time of the operation. There was a negative linear association between the outcome scores and the number of pack-years (p = 0.02). Cessation of smoking before the operation positively affected the outcome; the patients who had stopped smoking had a mean outcome score of 65 points, compared with 45 points for those who had not stopped (p = 0.03). Patients who had stopped smoking were also more likely to return to work full time (p < 0.001). At the latest follow-up evaluation, twenty of the seventy-two patients had returned to full-time employment. Patients who had been receiving Workers' Compensation at the time of the operation generally did poorly on the outcome questionnaire, but, with the numbers available, they did not have a significantly different rate of solid fusion than patients who had not been receiving Workers' Compensation. Also, the outcome score and the rate of fusion were nor significantly affected by age or by obesity.
تواريخ الأحداث: Date Created: 19960501 Date Completed: 19960717 Latest Revision: 20220311
رمز التحديث: 20221213
DOI: 10.2106/00004623-199605000-00011
PMID: 8642028
قاعدة البيانات: MEDLINE
الوصف
تدمد:0021-9355
DOI:10.2106/00004623-199605000-00011