[Lumbar arthrodesis: results after more than 10 years]

Area of Science:

• Spine Surgery
• Orthopedics
• Neurosurgery

Background:

• Chronic low back pain significantly impacts quality of life.
• Conservative treatments often fail for persistent spinal conditions.
• Lumbar spine fusion has been employed for decades to address intractable pain.

Purpose of the Study:

• To evaluate the long-term functional and clinical outcomes of lumbar spine fusion.
• To identify factors influencing the success or failure of lumbar fusion.
• To assess the correlation between radiographic findings and clinical results post-fusion.

Main Methods:

• Retrospective review of 274 patients undergoing lumbar spine fusion between 1949-1971.
• Detailed analysis of 75 patients with over 10 years of follow-up.
• Categorization of diagnoses including spondylolisthesis, degenerative disc disease, Pott's disease, and tumors.

Main Results:

• 74% of patients reported satisfactory clinical results after an average 13-year follow-up.
• Fusion success was better for isthmic spondylolisthesis than degenerative types.
• Outcomes were superior for pure low back pain compared to cases with sciatica.
• Limited fusion to one or two levels correlated with better results.
• No correlation found between long-term radiographic changes and clinical outcomes.

Conclusions:

• Lumbar spine fusion can provide satisfactory long-term relief for chronic low back pain.
• Patient selection and specific diagnoses are critical for successful fusion outcomes.
• While radiographic degeneration may occur, it does not necessarily predict poor clinical results.