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Improvement in physical function and reduced pain after instrumented lumbar interbody fusion – Lumbar Fusion

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The article discusses a study that examined the clinical and patient-reported outcomes of single-level instrumented interbody fusion surgery for severe low back pain. The study, based on data from the national Danish surgical spine database, included 460 patients. The primary outcome, the Oswestry Disability Index (ODI) score, improved significantly at the two-year follow-up. Secondary outcomes, including quality of life, pain scores, and patient satisfaction, also showed improvement. The study concludes that patients with severe back-related disability can expect improved physical function and reduced pain after undergoing instrumented lumbar interbody fusion. The study was not funded, and the registration information is available in the national Danish DaneSpine database

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most established spinal facility in London

Published article

CONCLUSIONS: Patients suffering from severe back-related disability after failed conservative treatment may expect an improvement in physical function and reduced pain after instrumented lumbar interbody fusion.

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Dan Med J. 2023 Aug 15;70(9):A08220508.ABSTRACTINTRODUCTION: Instrumented lumbar fusion has been used as surgical treatment for severe disability with associated low back pain. The overall effect and risks of the most commonly used instrumented lumbar fusion techniques are controversial. The objective of the study was to describe clinical and patient-reported outcomes in patients undergoing single-level,

Dan Med J. 2023 Aug 15;70(9):A08220508.

ABSTRACT

INTRODUCTION: Instrumented lumbar fusion has been used as surgical treatment for severe disability with associated low back pain. The overall effect and risks of the most commonly used instrumented lumbar fusion techniques are controversial. The objective of the study was to describe clinical and patient-reported outcomes in patients undergoing single-level instrumented interbody fusion surgery with either posterior or transforaminal lumbar interbody fusion.

METHODS: This was a registry-based cohort study on patients from the national Danish surgical spine database – DaneSpine. The primary outcome was Oswestry Disability Index (ODI) score at two-year follow-up. Secondary outcome measures were the 3-Level European Quality of Life-5 Dimensions (EQ5D-3L), a visual analogue scale (VAS) score, patient satisfaction and the rate of intraoperative complications.

RESULTS: The cohort included 460 patients. ODI improved from 48 ± 15 preoperatively to 33 ± 20 at the two-year follow-up (p less-than 0.001). The EQ5D-3L score improved from 0.279 ± 0.311 to 0.542 ± 0.340, the VAS score for leg pain from 60 ± 28 to 40 ± 32 and back pain from 70 ± 20 to 47 ± 30. Patient satisfaction was obtained in 58%; 24% were undecided, whereas 18% were not satisfied with the treatment outcome at their two-year follow-up.

CONCLUSIONS: Patients suffering from severe back-related disability after failed conservative treatment may expect an improvement in physical function and reduced pain after instrumented lumbar interbody fusion.

FUNDING: None.

TRIAL REGISTRATION: The national Danish DaneSpine registration.

PMID:37622642

The London Spine Unit : most established spinal facility in London

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Improvement in physical function and reduced pain after instrumented lumbar interbody fusion

Sciatica My mother was in absolute agony for more than 3 months due to sciatica. It just came out of nowhere and took her out of action. From working full time she went straight to being bed bound and unable to carry out simplest of actions.The pain was 9/10 and she was bed bound for those three months. Multiple trips to A&E and GP and they wouldn't class it as an emergency therefore they wouldn't do anything about it other than upgrading the painkillers which did next to nothing for my mother. I couldn't bear to watch my mother sleeping on A&E bench in pain for 7 hours, just to be told by doctors that she wouldn't be kept in. I remember her joining her hands and begging the doctors to stop the pain which broke my heart. I then started doing research on google and London spine unit came up with Dr Mo AKMAL's profile and review. First meeting with Dr AKMAL was via ZOOM as my mother was bed bound. Dr AKMAL spoke to me and my mom and told us that this is nothing to worry about and that the pain would be 100% gone.Dr AKMAL assured us to visit the hospital so he could physically inspect my mother and give us the best solution. One trip to the london spine unit and Dr AKMAL advised us that the best solution would be to carry out Minimally invasive disectomy. Dr AKMAL advised that due to my mother being bed bound for a while, steroid injection might not give the result that my mother wishes. Dr AKMAL was very confident and showed us some videos from other patients who had gone through the same ordeal. The biggest thing i noticed between before and after was the smile on the patients face. Dr AKMAL was constantly assuring my mother throughout the meeting that he would take care of her pain and gave her 100% confidence that the result would be delivered.He promised her that she would be walking pain free the same day after the operation. Before the operation Dr GURUNG was consulted multiple times and he also was very helpful. Right after the surgery, as Dr AKMAL promised, my mother was walking and the biggest thing was that the pain was gone. My mother had forgotten to smile for three months and there i saw her smiling again. Dr AKMAL and Dr GURUNG gave us brilliant aftercare and informed us that just give them a ring if there was any issue. Its been several weeks now and my mother is heading towards complete recovery without any issues. The pain is completely gone and anyone who is reading this going through the same horrible sciatica pain you must come and see Dr AKMAL. Thank you Dr AKMAL and your whole team for helping my mom achieve this pain free life.

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Dan Med J. 2023 Aug 15;70(9):A08220508.ABSTRACTINTRODUCTION: Instrumented lumbar fusion has been used as surgical treatment for severe disability with associated low back pain. The overall effect and risks of the most commonly used instrumented lumbar fusion techniques are controversial. The objective of the study was to describe clinical and patient-reported outcomes in patients undergoing single-level

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