Open Access
CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(06): 766-771
DOI: 10.1055/s-0041-1724083
Artigo Original
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Lumbar Decompression Versus Spinal Fusion in a Private Outpatient Setting: A Retrospective Study with Three Years of Follow-up[*]

Article in several languages: português | English
1   Departamento de Ortopedia e Traumatologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
2   Instituto Wilson Mello, Campinas, SP, Brasil
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1   Departamento de Ortopedia e Traumatologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
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1   Departamento de Ortopedia e Traumatologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
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1   Departamento de Ortopedia e Traumatologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
› Author Affiliations
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Abstract

Objective To compare pain, function, quality of life and adverse events of lumbar decompression and spinal fusion in patients with degenerative spinal pathologies who participated in a second opinion program for spinal surgeries with a 36-month follow-up.

Methods The data for this retrospective cohort were withdrawn from a private healthcare system between June 2011 and January 2014. The study sample consisted of 71 patients with a lumbar spine surgical referral. The outcomes for the comparisons between lumbar decompression and spinal fusion were quality of life (evaluated through the EuroQoL 5D), pain (measured by the Numerical Rating Scale) and function (assessed through the Roland Morris Disability Questionnaire) measured at baseline, and at 12 and 36 months after the surgical procedures. The definitions of recovery were established by the minimal clinically important difference (MCID). The baseline differences between the groups were analyzed by non-paired t-test, and the differences in instrument scores between time points, by generalized mixed models. The results were presented as mean values adjusted by the models and 95% confidence intervals.

Results Concerning the surgical techniques, 22 patients were submitted to spinal fusion and 49 patients, to lumbar decompression. As for the comparisons of the findings before and after the surgical interventions, the MCID was achieved in all outcomes regarding quality of life, pain and function at both time points when compared to baseline scores Moreover, concerning the complication rates, only lumbar decompression presented a surgical rate of 4% (n = 3) for recurrence of lumbar disc hernia.

Conclusion Patients with degenerative spinal pathologies present improvements in long-term outcomes of pain, function and quality of life which are clinically significant, no matter the surgical intervention.

Authors' Contributions

All authors conceived the study. IOO chose the study design, and ML, EA and MF helped with the final version of the manuscript. IOO and EA were involved in the statistical analysis. All authors contributed to the refinement of the study and approved the final manuscript.


Financial Support

There was no financial support from public, commercial, or non-profit sources.


* Work developed at the Department of Orthopedics and Traumatology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.




Publication History

Received: 24 July 2020

Accepted: 17 September 2020

Article published online:
11 September 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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