Article

PURPOSE: To assess the disability and relationship between functional status and
health related quality of life (HRQoL) in patients in the early recovery phase
following spinal fusion. METHODS: This is a prospective cohort study. Since 2008
data of spinal fusion patients have been collected prospectively in two Finnish
hospitals. In August 2009, complete data of 173 patients were available. The
measurement tool of disability was the Oswestry Disability Index (ODI) and it was
also examined in the framework of International Classification of Functioning,
Disability and Health (ICF) using body functions and structures, activities and
participation components. RESULTS: Preoperatively the mean total ODI was 45
(SD17) and mean (95% confidence interval) change to 3 months postoperatively was
-19 (-22 to -17). When the ODI was linked to the ICF, there was a 55% improvement
in the body structure and functions component and a 44% improvement in both the
activities and the participation components. However, 25% of the patients still
had the total ODI score over 40 three months postoperatively. Preoperatively, the
mean (95% CI) Physical Component Summary Score (PCS) of the Short Form
36-questionnaire (SF-36) was 27 (26 to 28) and the mean Mental Component Summary
Score (MCS) of SF-36 was 47 (45 to 49). Postoperatively the improvement was 9
(95% CI: 8 to 11) in PCS and 6 (95% CI: 4 to 7) in MCS (p < 0.001). CONCLUSIONS:
Spinal fusion is successful in the early recovery period in terms of reduction of
pain and disability. The significant changes in the ODI were seen in all three
components of the ICF model. In addition, improvement in functioning was
significantly related to positive change in HRQoL. Still there is a subgroup of
patients having marked disability needing more intensive rehabilitation and
follow-ups.

Langue : ANGLAIS