Comparison of biomechanical changes in respect of pain scores after lumbar fusion

Abstract

Low back pain is one of the leading causes of disability, some patients don’t respond to conservative therapy, and must undergo surgery. The aim of our study was to investigate the results of lumbar fusion operations, especially considering the changes in the sagittal range of motion (ROM) in the adjacent segments, thoracic, lumbar region and pain. 13 patients were involved, who had lumbar LIV/V rigid fusion (TLIF) operation, and still had low back pain symptoms. For the biomechanical measurement we used the Spinal Mouse, a computer associated device, based on electromagnetic impulses. For estimating the pain we used the 3D pain questionnaire (West-Haven-Yale Multidimensonal Pain Inventory [WHYMPI]). In the outline analysis we found that the decrease in pain and improvement of symptoms after a lumbar fusion is defi nitely the result of increased thoracic segment hypermobility, decreased lumbar segment hypomobility, decreased proximal adjacent segment hypomobility and, increase of the distal adjacent segment hypomobility. The sagittal range of motion (ROM) of the whole spine, as the hypomobility is corrected towards the normal ROM resulted in decrease of pain. In conclusion we can notice when using semirigid systems for bridging adjacent segments, it is important to secure the hypermobility of the thoracic spine, and the mobility of the proximal segment. DOI: 10.17489/biohun/2010/1/05