Poster 212: Clinical Correlations With Number of Vertebral Levels Fused in Patients With Chronic Low Back Pain

Abstract

Objective: To investigate clinical characteristics and multidisciplinary rehabilitation outcomes for chronic low back pain (LBP) patients based on number of lumbar levels fused. Design: Retrospective pre- and post-treatment study. Setting: Tertiary care center. Participants: 111 patients with disabling LBP and prior history of lumbar fusion, admitted to a multidisciplinary pain rehabilitation program from January 2000 to April 2006. Interventions: Intensive, outpatient-based, multidisciplinary rehabilitation with analgesic medication withdrawal. Main Outcome Measures: The Multidimensional Pain Inventory, Center for Epidemiologic Studies−Depression Scale, catastrophizing subscale of the Coping Strategies Questionnaire, and opioid medication usage. Results: 46 patients had 1 level fused, 41 patients had 2 levels fused, 15 patients had 3 levels fused, 6 patients had 4 levels fused, and 3 patients had 6 levels fused. Age (r=.35, P=.000), years of education (r=.29, P=.002), and duration of symptoms (r=.29, P=.002) correlated positively with number of levels fused. Other admission and dismissal measures did not correlate significantly with number of levels fused. To correct for multiple comparisons, statistical significance was determined at P<.0025. Conclusions: Of patients with history of lumbar fusion admitted to a multidisciplinary rehabilitation program for chronic disabling back pain, older, more educated patients with greater duration of symptoms were more likely to have more lumbar levels fused. Rehabilitation outcome measures were not associated with number of levels fused.