QUALITY OF LIFE IN THE PRE- AND POSTOPERATIVE PERIODS IN SPINAL FUSION AND DISCECTOMY

Rufca, Gibran Franzoni; Romero, Flavio Ramalho; Rufca, Drielly Lívia Cristino Braga; Silva, Bruna da; Oliveira, Catilaine de; Lima, Hellen Juliana de

doi:10.1590/S1808-185120191801192302

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Original Article, Surgical Technique • Coluna/Columna 18 (1) • Jan-Mar 2019 • https://doi.org/10.1590/S1808-185120191801192302 copy

QUALITY OF LIFE IN THE PRE- AND POSTOPERATIVE PERIODS IN SPINAL FUSION AND DISCECTOMY

QUALIDADE DE VIDA PRÉ E PÓS-OPERATÓRIA DA ARTRODESE DE COLUNA E DISCECTOMIA

CALIDAD DE VIDA EN LOS PERIODOS PRE Y POSTOPERATORIO EN ARTRODESIS DE COLUMNA Y DISCECTOMÍA

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

Considering the epidemiological and functional importance of spinal pathologies and the large number of surgeries performed today, the study aimed to evaluate the impact of spinal arthrodesis and discectomy surgeries on patients’ quality of life.

Methods:

This is a retrospective, descriptive, and longitudinal study developed in the neurology and neurosurgery department of a strategic tertiary hospital in an inland town in the state of São Paulo. Data were collected through a telephone interview, using the Oswestry questionnaire (ODI) to assess lumbar pain in patients submitted to surgery in 2014 and 2015.

Results:

There was an improvement in the ODI results in all the periods analyzed. When the evaluations were subdivided by surgical type, there was an absolute improvement in the median ODI results in all procedures, however, only the cervical spine arthrodesis procedure was not statistically significant, probably due to the low number of procedures analyzed (n = 12).

Conclusion:

It can be concluded that the current surgical technique can contribute to the improvement of patients’ quality of life. Level of Evidence III; Comparative retrospective study.

Keywords:
Spinal fusion; Intervertebral disc displacement; Quality of life

Sex	N
Male	37
Female	33
Age group	N
10 To 20 years	1
21 To 30 years	9
31 To 40 years	12
41 To 50 years	19
51 To 60 years	20
61 To 70 years	7
> 71 Years	2
Diagnosis	N
Spinal cord stenosis	24
Disc hernia	20
Cervical disc hernia	5
Thoracolumbar SCI^* * SCI – Spinal Cord Injury;	15
Cervical SCI	5
Infectious discitis	1
Surgery performed	N
Discectomy	19
Cervical arthrodesis ant⁺ + ANT. – Anterior;	9
Cervical arthrodesis post^$ $ POST. – Posterior.	3
Lumbar arthrodesis post	36
Thoracic arthrodesis post	3

Procedure	Period	Pre-op	Post-op
Discectomy	Up to 12 months	52%	20%
P < 0.05	13 To 18 months	56%	19%
N = 19	19 To 24 months	80%	6%
	More than 24 months	62%	12%
Thoracolumbar arthrodesis via posterior	Up to 12 months	62%	19%
P<0.05	13 To 18 months	63%	29%
N = 39	19 To 24 months	60%	45%
	More than 24 months	72%	27%

Cervical spine arthrodesis	Up to 12 months	60%	1%
P>0.05	13 To 18 months	58%	8%
N = 12	19 To 24 months	33%	39%
	More than 24 months	64%	58%

Sociedade Brasileira de Coluna Al. Lorena, 1304 cj. 1406/1407, 01424-001 São Paulo, SP, Brasil, Tel.: (55 11) 3088-6616 - São Paulo - SP - Brazil
E-mail: coluna.columna@uol.com.br

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[1] Correspondence: Gibran Franzoni Rufca. Rua Candido Correa de Araújo, 64, Residencial Matioli, Ourinhos, SP, Brazil. 19901750. gibran.rufca@gmail.com

Oswestry low back pain questionnaire
Please answer this questionnaire. It was developed to provide us with information about how your back or leg problem has affected your ability to carry out activities of daily living. Please answer all the sections. In each one, mark only the response that most clearly describes your condition at the moment.
Section 1 – pain intensity () I feel no pain at the moment. () the pain is very mild at the moment. () The pain is moderate at the moment. () The pain is fairly severe at the moment. () The pain is very severe at the moment. () the pain is the worst imaginable at the moment.	Section 6 – Standing () I can stand as long as I want without extra pain () I can stand as long as I want but it gives me extra pain () Pain prevents me from standing for more than 1 hour () Pain prevents me from standing for more than 30 minutes () Pain prevents me from standing for more than 10 minutes () Pain prevents me from standing at all
Section 2 – Personal care (washing, dressing etc.) () I can look after myself normally without causing extra pain () I can look after myself normally but it causes extra pain () It is painful to look after myself and I am slow and careful () I need some help but manage most of my personal care () I need help every day in most aspects of self-care () I do not get dressed, I wash with difficulty and stay in bed	Section 7 – Sleeping ()My sleep is never disturbed by pain ()My sleep is occasionally disturbed by pain ()Because of pain I have less than 6 hours sleep ()Because of pain I have less than 4 hours sleep ()Because of pain I have less than 2 hours sleep ()Pain prevents me from sleeping at all
Section 3 – Lifting () I can lift heavy weights without extra pain () I can lift heavy weights but it gives extra pain () Pain prevents me from lifting heavy weights off the floor, but I can manage if they are conveniently placed e.g. on a table () Pain prevents me from lifting heavy weights, but I can manage light to medium weights if they are conveniently positioned () I can lift very light weights () I cannot lift or carry anything at all	Section 8 – Sex life ()My sex life is normal and causes no extra pain ()My sex life is normal but causes some extra pain ()My sex life is nearly normal but is very painful ()My sex life is severely restricted by pain ()My sex life is nearly absent because of pain ()Pain prevents any sex life at all
Section 4 – Walking () Pain does not prevent me walking any distance () Pain prevents me from walking more than 1 mile () Pain prevents me from walking more than ½ mile () Pain prevents me from walking more than 100 yards () I can only walk using a stick or crutches () I am in bed most of the time and need to drag myself to go to the bathroom.	Section 9 – Social life ()My social life is normal and gives me no extra pain ()My social life is normal but increases the degree of pain ()Pain has no significant effect on my social life apart from limiting my more energetic interests e.g., sport ()Pain has restricted my social life and I do not go out as often ()Pain has restricted my social life to my home () I have no social life because of pain
Section 5 – Sitting () I can sit in any chair as long as I like () I can only sit in my favorite chair as long as I like () Pain prevents me sitting more than one hour () Pain prevents me sitting more than 30 minutes () Pain prevents me from sitting more than 10 minutes () Pain prevents me from sitting at all.	Section 10 – Traveling (bus/car/tax) () I can travel anywhere without pain. () I can travel anywhere but it gives me extra pain. () Pain is bad but I manage journeys over two hours. () Pain restricts me t journeys of less than one hour. ()Pain restricts me to short necessary journeys under 30 minutes. () Pain prevents me from travelling except to receive treatment.