Abstract
Introduction
Degeneration of the lumbar spine is a common and age-related finding in the normal population (1;2). Several factors may contribute to lumbar disk degeneration, such as ageing, genetic, and fusion (3). Patients treated for disk degeneration and CLBP may be more prone to further degeneration than the rest of the population. We hypothesized that degeneration of the disks will proceed independent of fusion, also within the fused segments.
Materials and Methods
A total of 124 patients were included in the original two studies (4–6). At 9-year follow-up, baseline and long-term radiographs were available in 48 patients, 23 had lumbar fusion, and 25 had no lumbar fusion. Measurements of disk height were performed with Distortion Compensated Roentgen Analysis (DCRA) (7). Three levels were examined; one operated level (L4/L5), and two nonoperated levels (L2/L3 and L3/L4). The Norwegian version (1.0) of the Oswestry disability index (ODI) (8;9) was used to evaluate condition-specific disability and pain. Back pain was measured on a vertical visual analogue scale from 0 to 100 wherein 100 reflected the worst pain imaginable. Maximum pain, minimum pain, and current pain were scored on three different scales. The mean of the three scores provided the pain index for back pain (10)
Results
Disk height was reduced in both groups at levels L3/L4, and L4/L5, but not formally significant (p = 0.06) at L2/L3 with no disk height differences between the operated and nonoperated group at any level at 9-year follow-up. ODI and back pain were improved in both groups from baseline to 9-year follow-up, but ODI and back pain correlated poorly with disk degeneration at 9-year follow-up.
Conclusion
Disk height was decreased from baseline to 9-year follow-up with no differences between groups and no association between pain and back disability and disk height.
Yes
None declared
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