Outcome of Spinal Fusion for Lumbar Degenerative Disease: A Cross-Sectional Study in Korea

Retrospective cross-sectional study. To evaluate the degree of postoperative pain and patients' satisfaction after lumbar fusion from a nationwide survey in Korea. There have been few studies that investigated the factors related to patients' satisfaction after spinal fusion in lumbar degenerative disease (LDD). This study included 629 patients who underwent spinal fusion for LDD at clinics of designated members of the Korean Society of Spine Surgery. This survey was done in 123 hospitals with 171 spine surgeons. Questionnaires for patients included severity of present back pain and radicular pain (visual analog scale score), Oswestry Disability Index (ODI), and subjective outcomes. Questionnaire for surgeons included preoperative diagnosis, level of fusion, operative method, and presumed patient's pain. The patients were 199 men and 430 women, with mean age of 62.3 years. The mean visual analog scale score of back pain and radicular pain was 5.0 +/- 2.6 and 4.4 +/- 3.0, respectively. The mean ODI was 44.3 +/- 19.4. ODI was significantly increased with older age, workers' compensation, and increased fusion extent. Correlated factors of dissatisfaction were severe back pain, higher ODI, multiple operation, and insufficient explanation about postoperative pain. There was a significant correlation between preoperative explanation about postoperative pain and degree of patient's pain. Patients' satisfaction was not as high as expected after fusion for LDD. Therefore, the decision for performing a lumbar fusion in those patients must be done more carefully, and it should be explained more precisely that chronic pain may persist after spinal surgery.