The ‘Lumbar Fusion Outcome Score’ (LUFOS): a new practical and surgically oriented grading system for preoperative prediction of surgical outcomes after lumbar spinal fusion in patients with degenerative disc disease and refractory chronic axial low back pain
| Autor: | Jean C. Aldag, Dzung H. Dinh, Azeem A. Rehman, Tobias A. Mattei, Todd D. McCall, Alisson Roberto Teles |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Visual analogue scale Intervertebral Disc Degeneration Degenerative disc disease Young Adult 03 medical and health sciences 0302 clinical medicine Lumbar Back pain Humans Medicine Pain Measurement 030222 orthopedics Lumbar Vertebrae medicine.diagnostic_test business.industry Lumbosacral Region Magnetic resonance imaging General Medicine Middle Aged medicine.disease Magnetic Resonance Imaging Low back pain Oswestry Disability Index Surgery Spinal Fusion Treatment Outcome Female Neurology (clinical) Neurosurgery Chronic Pain medicine.symptom business Low Back Pain 030217 neurology & neurosurgery |
| Zdroj: | Neurosurgical Review. 40:67-81 |
| ISSN: | 1437-2320 0344-5607 |
| DOI: | 10.1007/s10143-016-0751-6 |
| Popis: | In order to evaluate the predictive effect of non-invasive preoperative imaging methods on surgical outcomes of lumbar fusion for patients with degenerative disc disease (DDD) and refractory chronic axial low back pain (LBP), the authors conducted a retrospective review of 45 patients with DDD and refractory LBP submitted to anterior lumbar interbody fusion (ALIF) at a single center from 2007 to 2010. Surgical outcomes - as measured by Visual Analog Scale (VAS/back pain) and Oswestry Disability Index (ODI) - were evaluated pre-operatively and at 6 weeks, 3 months, 6 months, and 1 year post-operatively. Linear mixed-effects models were generated in order to identify possible preoperative imaging characteristics (including bone scan/99mTc scintigraphy increased endplate uptake, Modic endplate changes, and disc degeneration graded according to Pfirrmann classification) which may be predictive of long-term surgical outcomes . After controlling for confounders, a combined score, the Lumbar Fusion Outcome Score (LUFOS), was developed. The LUFOS grading system was able to stratify patients in two general groups (Non-surgical: LUFOS 0 and 1; Surgical: LUFOS 2 and 3) that presented significantly different surgical outcomes in terms of estimated marginal means of VAS/back pain (p = 0.001) and ODI (p = 0.006) beginning at 3 months and continuing up to 1 year of follow-up. In conclusion, LUFOS has been devised as a new practical and surgically oriented grading system based on simple key parameters from non-invasive preoperative imaging exams (magnetic resonance imaging/MRI and bone scan/99mTc scintigraphy) which has been shown to be highly predictive of surgical outcomes of patients undergoing lumbar fusion for treatment for refractory chronic axial LBP. |
| Databáze: | OpenAIRE |
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