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SPINAL FUSION: A TEN YEAR ANALYSIS FROM THE SERVICEMAN’S PERSPECTIVE.



Abstract

INTRODUCTION: Chronic back ache is a common disorder which rarely indicates surgery. There are accepted indications for surgical intervention; namely that of neurogenic leg pain in the presence of spondylolisthesis or gross instability of the lower lumbar segments. There have been no studies looking at the long term follow-up of service personnel following spinal fusion. The activities demanded by service life exert significant strain on the axial spine and there are no figures documenting the return to full service post-surgery.

METHOD: A retrospective review of case notes of service personnel undergoing spinal fusion at the Royal Hospital Haslar was performed from 1990 onwards. 65 patients were identified and their case notes analysed. The following information was obtained:

Age, sex, pre-operative diagnosis, medical category pre-op, non-operative treatment, surgical procedure, post-operative rehabilitation, medical category post-surgery and whether still serving.

ANALYSIS: Outcome parameters: medical category post surgery, and ability to continue serving in the armed services.

DISCUSSION: Successful results from spinal surgery depends on good patient selection and the development of a treatment protocol. From a service perspective, a successful surgical outcome would result in the return of a service person back to their operational role. We discuss a potential treatment algorithm for the surgical management of low back pain.

These abstracts were prepared by Squadron Leader G. Pathak FRCS (Trauma & Orth). Correspondence should be addressed to him at Royal Hospital Haslar, Gosport, Hampshire PO12 2AA.