Mark D Brown1, Kathleen F Wehman, Anneliese D Heiner. 1. Department of Orthopaedics and Rehabilitation, University of Miami School of Medicine, Miami, Florida 33101, USA. mbrown@med.miami.edu
Abstract
STUDY DESIGN: Determination of clinical results at least 2 years after lumbar spine surgery during which spinal stiffness measurements were made. OBJECTIVES: To determine whether spine stiffness is predictive of clinical results after lumbar spine surgery for spinal stenosis, disc herniation, or degenerative spondylolisthesis. SUMMARY OF BACKGROUND DATA: The implied clinical wisdom is that instability of the spine portends a poor prognosis for relief of back pain after surgery in the absence of a fusion. The possibility that an objective measure of lumbar spinal motion segment unit stiffness could aid the surgeon in predicting satisfaction with treatment was considered. METHODS: A total of 298 patients were measured intraoperatively with the spinal stiffness gauge to determine motion segment stiffness. Intraoperative spinal stiffness was analyzed to determine the influence of this measurement on clinical results. RESULTS: Statistical analysis revealed that stiffness measurements did not correlate with clinical results of surgery. Patients with loose motion segment units before decompression did not demonstrate a significantly different level of satisfaction with surgical results a minimum of 2 years after surgery, whether they were fused or not fused. Based on stiffness measurements, a diagnosis of herniated nucleus pulposus or degenerative spondylolisthesis was indicative of a more unstable spine than a diagnosis of spinal stenosis. CONCLUSIONS: Intraoperative spinal stiffness measurements did not predict clinical results after lumbar spine surgery.
STUDY DESIGN: Determination of clinical results at least 2 years after lumbar spine surgery during which spinal stiffness measurements were made. OBJECTIVES: To determine whether spine stiffness is predictive of clinical results after lumbar spine surgery for spinal stenosis, disc herniation, or degenerative spondylolisthesis. SUMMARY OF BACKGROUND DATA: The implied clinical wisdom is that instability of the spine portends a poor prognosis for relief of back pain after surgery in the absence of a fusion. The possibility that an objective measure of lumbar spinal motion segment unit stiffness could aid the surgeon in predicting satisfaction with treatment was considered. METHODS: A total of 298 patients were measured intraoperatively with the spinal stiffness gauge to determine motion segment stiffness. Intraoperative spinal stiffness was analyzed to determine the influence of this measurement on clinical results. RESULTS: Statistical analysis revealed that stiffness measurements did not correlate with clinical results of surgery. Patients with loose motion segment units before decompression did not demonstrate a significantly different level of satisfaction with surgical results a minimum of 2 years after surgery, whether they were fused or not fused. Based on stiffness measurements, a diagnosis of herniated nucleus pulposus or degenerative spondylolisthesis was indicative of a more unstable spine than a diagnosis of spinal stenosis. CONCLUSIONS: Intraoperative spinal stiffness measurements did not predict clinical results after lumbar spine surgery.