Ontology type: schema:ScholarlyArticle Open Access: True
2018-03
AUTHORSHåvard Furunes, Christian Hellum, Jens Ivar Brox, Ivar Rossvoll, Ansgar Espeland, Linda Berg, Helga Maria Brøgger, Milada Cvancarova Småstuen, Kjersti Storheim
ABSTRACTPURPOSE: We aimed to identify patient characteristics associated with favourable long-term outcomes after lumbar total disc replacement (TDR). METHODS: We analysed a cohort of 82 patients with degenerative disc and chronic low back pain (LBP) who were treated with TDR and originally participated in a randomised trial comparing TDR and multidisciplinary rehabilitation. Potential predictors were measured at baseline, and the outcomes assessed 8 years after they received allocated treatment. Outcome measures were dichotomised according to whether the participants achieved a clinically important functional improvement (15 points or more on the Oswestry Disability Index, ODI) (primary outcome) and whether they were employed at 8-year follow-up (secondary outcome). Associations between potential predictors and outcomes were modelled using logistic regression. For the secondary outcome, the results were also organised in a prediction matrix and expressed as probabilities. RESULTS: For 71 patients treated with TDR according to protocol, the follow-up time was 8 years. For a subgroup of 11 patients randomised to rehabilitation who crossed over and received TDR, the median postoperative follow-up time was 72 (range 41-88) months. Of all assessed baseline variables, only presence of Modic changes (type 1 and/or 2) was statistically significantly associated with an improvement of ≥ 15 ODI points. The probability of employment at 8-year follow-up was 1% for patients with ≥ 1 year of sick leave, comorbidity, ODI ≥ 50 and ≤ 9 years of education prior to treatment, and 87% for patients with < 1 year of sick leave, no comorbidity, ODI < 50 and higher education. CONCLUSIONS: Patients with Modic changes prior to the TDR surgery were more likely to report a clinically important functional improvement at long-term follow-up. Comorbidity, low level of education, long-term sick leave and high ODI score at baseline were associated with unemployment at long-term follow-up. More... »
PAGES709-718
http://scigraph.springernature.com/pub.10.1007/s00586-017-5375-1
DOIhttp://dx.doi.org/10.1007/s00586-017-5375-1
DIMENSIONShttps://app.dimensions.ai/details/publication/pub.1092536994
PUBMEDhttps://www.ncbi.nlm.nih.gov/pubmed/29103126
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"description": "PURPOSE: We aimed to identify patient characteristics associated with favourable long-term outcomes after lumbar total disc replacement (TDR).\nMETHODS: We analysed a cohort of 82 patients with degenerative disc and chronic low back pain (LBP) who were treated with TDR and originally participated in a randomised trial comparing TDR and multidisciplinary rehabilitation. Potential predictors were measured at baseline, and the outcomes assessed 8\u00a0years after they received allocated treatment. Outcome measures were dichotomised according to whether the participants achieved a clinically important functional improvement (15 points or more on the Oswestry Disability Index, ODI) (primary outcome) and whether they were employed at 8-year follow-up (secondary outcome). Associations between potential predictors and outcomes were modelled using logistic regression. For the secondary outcome, the results were also organised in a prediction matrix and expressed as probabilities.\nRESULTS: For 71 patients treated with TDR according to protocol, the follow-up time was 8\u00a0years. For a subgroup of 11 patients randomised to rehabilitation who crossed over and received TDR, the median postoperative follow-up time was 72 (range 41-88) months. Of all assessed baseline variables, only presence of Modic changes (type 1 and/or 2) was statistically significantly associated with an improvement of\u00a0\u2265\u00a015 ODI points. The probability of employment at 8-year follow-up was 1% for patients with\u00a0\u2265\u00a01\u00a0year of sick leave, comorbidity, ODI\u00a0\u2265\u00a050 and\u00a0\u2264\u00a09\u00a0years of education prior to treatment, and 87% for patients with\u00a0<\u00a01\u00a0year of sick leave, no comorbidity, ODI\u00a0<\u00a050 and higher education.\nCONCLUSIONS: Patients with Modic changes prior to the TDR surgery were more likely to report a clinically important functional improvement at long-term follow-up. Comorbidity, low level of education, long-term sick leave and high ODI score at baseline were associated with unemployment at long-term follow-up.",
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"name": "European Spine Journal",
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"name": "Lumbar total disc replacement: predictors for long-term outcome",
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