Abstract
ABSTRACT Objective: To evaluate whether the presence of osteolysis around the pedicle screws affects the quality of life of patients who underwent posterolateral arthrodesis of the lumbosacral spine. Methods: A retrospective study of patients undergoing lumbar posterolateral or lumbosacral arthrodesis due to spinal degenerative disease. CT scans of the operated segments were performed at intervals of 45, 90, 180, and 360 postoperatively. In these tests, the presence of a peri-implant radiolucent halo was investigated, which was considered present when greater than 1mm in the coronal section. Concurrently with the completion of CT scans, the participants completed the questionnaire Oswestry Disability Index (ODI) to assess the degree of disability of the patients. Results: A total of 38 patients were evaluated, and 14 (36.84%) of them showed some degree of osteolysis around at least one pedicle screw at the end of follow-up. Of the 242 analyzed screws, 27 (11.15%) had osteolysis in the CT coronal section, with the majority of these occurrences located at the most distal level segment of the arthrodesis. There was no correlation between the presence of the osteolysis to the quality of life of patients. The quality of life has significantly improved when comparing the preoperative results with the postoperative results at different times of application of ODI. This improvement in ODI maintains linearity over time. Conclusion: There is no correlation between the presence of peri-implant osteolysis to the quality of life of patients undergoing lumbar or posterolateral lumbosacral arthrodesis in the follow-up period up to 360 days. The quality of life in postoperative has significantly improvement when compared to the preoperative period.
Highlights
Low back pain or chronic lumbociatalgia, defined as pain lasting more than three months, is the second biggest cause of visits to the doctor and the main cause of absence from work in the USA
The aim of this study is to evaluate the presence of osteolysis around each of the pedicle screws used in surgical arthrodesis procedures and the time to its occurrence during the first postoperative year, and to correlate this finding with the levels of disability of patients during their evolution, through the application of the Oswestry Disability Index (ODI)
This is a retrospective analysis study of patients submitted to surgical treatment of the vertebral spine, with lumbar or lumbosacral posterolateral arthrodesis instrumented with pedicle screws
Summary
Low back pain or chronic lumbociatalgia, defined as pain lasting more than three months, is the second biggest cause of visits to the doctor and the main cause of absence from work in the USA. It affects 5% to 8% of the general population, and is reported by 19% of the economically active population, generating costs of more than a hundred billion dollars each year.[1,2] There is a wide spectrum of treatments available for patients with chronic low back pain resulting from degenerative changes to the vertebral spine, including conservative and surgical alternatives.[2]. Lumbar arthrodesis has been indicated as one of the treatment alternatives in selected cases of degenerative diseases of the vertebral spine with instability, including scoliosis, spondylolisthesis, and narrowing of the lumbar canal,[2,3] proving efficient, when properly indicated, and resulting in an improvement in the pain and other disabilities generated by these pathologies.[1,2,3,4]
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