Purpose: To assess the disability and relationship between
functional status and health related quality of life (HRQoL) in
patients in the early recovery phase following spinal fusion.
Methods: This is a prospective cohort study. Since 2008 data
of spinal fusion patients have been collected prospectively in
two Finnish hospitals. In August 2009, complete data of 173
patients were available. The measurement tool of disability
was the Oswestry Disability Index (ODI) and it was also
examined in the framework of International Classification of
Functioning, Disability and Health (ICF) using body functions
and structures, activities and participation components. Results:
Preoperatively the mean total ODI was 45 (SD17) and mean
(95% confidence interval) change to 3 months postoperatively
was −19 (−22 to −17). When the ODI was linked to the ICF,
there was a 55% improvement in the body structure and
functions component and a 44% improvement in both the
activities and the participation components. However, 25%
of the patients still had the total ODI score over 40 three
months postoperatively. Preoperatively, the mean (95% CI)
Physical Component Summary Score (PCS) of the Short Form
36-questionnaire (SF-36) was 27 (26 to 28) and the mean
Mental Component Summary Score (MCS) of SF-36 was 47 (45
to 49). Postoperatively the improvement was 9 (95% CI: 8 to
11) in PCS and 6 (95% CI: 4 to 7) in MCS (p < 0.001). Conclusions:
Spinal fusion is successful in the early recovery period in terms
of reduction of pain and disability. The significant changes in
the ODI were seen in all three components of the ICF model.
In addition, improvement in functioning was significantly
related to positive change in HRQoL. Still there is a subgroup
of patients having marked disability needing more intensive
rehabilitation and follow-ups.
Purpose: To assess the disability and relationship betweenfunctional status and health related quality of life (HRQoL) inpatients in the early recovery phase following spinal fusion.Methods: This is a prospective cohort study. Since 2008 dataof spinal fusion patients have been collected prospectively intwo Finnish hospitals. In August 2009, complete data of 173patients were available. The measurement tool of disabilitywas the Oswestry Disability Index (ODI) and it was alsoexamined in the framework of International Classification ofFunctioning, Disability and Health (ICF) using body functionsand structures, activities and participation components. Results:Preoperatively the mean total ODI was 45 (SD17) and mean(95% confidence interval) change to 3 months postoperativelywas −19 (−22 to −17). When the ODI was linked to the ICF,there was a 55% improvement in the body structure andfunctions component and a 44% improvement in both theactivities and the participation components. However, 25%of the patients still had the total ODI score over 40 threemonths postoperatively. Preoperatively, the mean (95% CI)Physical Component Summary Score (PCS) of the Short Form36-questionnaire (SF-36) was 27 (26 to 28) and the meanMental Component Summary Score (MCS) of SF-36 was 47 (45to 49). Postoperatively the improvement was 9 (95% CI: 8 to11) in PCS and 6 (95% CI: 4 to 7) in MCS (p < 0.001). Conclusions:Spinal fusion is successful in the early recovery period in termsof reduction of pain and disability. The significant changes inthe ODI were seen in all three components of the ICF model.In addition, improvement in functioning was significantlyrelated to positive change in HRQoL. Still there is a subgroupof patients having marked disability needing more intensiverehabilitation and follow-ups.
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