A new study published in The Spine Journal examines the independent predictors of lumbar spinal fusion patient improvement.
The researchers examined 231 patients who underwent lumbar fusion for any indication. There was a blinded reviewer who examined and assessed radiographs for the patients, analyzing the sagittal alignment after surgery. The researchers found:
1. There were 58 percent of the patients who exceeded minimum clinically important difference thresholds for the EuroQOL-5 Dimensions of 0.1. Another 16 percent exceeded the MCID value of 0.39.
2. The independent predictors of not reaching clinically significant improvement of 0.1 that were statistically significant include:
- Higher preoperative EQ-5D score
- L5-S1 fusion
3. Among the patients with a MCID value of 0.39, the statistically significant independent predictors of not achieving clinically significant improvement were:
- Diagnosis of depression
- Higher preoperative EQ-5D score
4. Spondylolisthesis was a predictor of achieving clinically significant improvement postoperatively among the patients with a 0.39 MCID value.
5. The patients who achieved clinically significant improvement in both groups reported a better postoperative quality of life score after surgery even though they had worse quality of life scores before surgery.
"This study is the first to use a combination of medical, surgical and postoperative sagittal balance variables as determinants for the achievement of CSI after lumbar fusion," the study authors reported. "The awareness of these predictors may allow for better patients selection and surgical approach to decrease the probability of acquiring a poor outcome postoperatively."