A recent study, published in The Journal of Craniovertebral Junction and Spine by lead author, Ara Deukmedjian, MD, shows that a combined fusion can be a safe and effective treatment for lower back pain.
Here are five key points:
1. The goal of the study was to evaluate the safety and effectiveness of lumbar fusion in the treatment of lower back pain due to degenerative disc disease.
2. There were 205 patients with single or multilevel DDD underwent lumbar decompression and instrumented fusion for the treatment of chronic lumbar back pain from 2008 to 2011.
3. Primary outcomes measured in this study were back and leg pain visual analogues scale, patient reported percent resolution of preoperative back pain and leg pain, reoperation rate, perioperative complications, blood loss and hospital length of stay.
4. Here are the results:
- Patients had an 84 percent resolution of back pain, while the average resolution of preoperative leg pain was 90 percent.
- Average visual analogues scale for combined back and leg pain significantly improved from a preoperative value of 9.0 to a postoperative value of 1.1, a difference of 7.9 points.
- Average number of lumbar disc levels fused per patient was 2.3, and the median postoperative length of stay in the hospital was 1.2 days.
- Average blood loss was 108 ml per fused level.
- Complications occurred in 5 percent of patients and the rate of reoperation for symptomatic adjacent segment disease was 2 percent. These included a reoperation at index level for symptomatic pseudoarthrosis with hardware failure, surgical site infection, repair of cerebrospinal fluid leak and one patient death at home three days after discharge.
- There was a long-term follow up of 2 years with data to support.
5. In conclusion, lumbar fusion for symptomatic DDD can be a safe and effective treatment for medically refractory lower back pain with or without leg pain.