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AUDITING FUNCTIONAL IMPROVEMENTS FOLLOWING LUMBAR FUSION IN PRIVATE PRACTICE – A FIVE-YEAR STUDY



Abstract

Introduction and Aims: Outcome studies in select patient groups in a research environment risk reporting findings that may not be relevant to the large percentage of patients undergoing surgery in private practice in the community. This paper reports an audit of outcomes improvement in Lumbar Fusion patients using the Modified Rowland Questionnaire (MRQ).

Method: Two hundred and sixteen patients undergoing lumbar fusion procedures, over a five-year period, completed the MRQ prior to surgery and at the routine one-year follow-up. Changes to the score were documented and analysed in relation to diagnosis, third party compensation coverage, and revision procedures. The MRQ is a validated responsive disease specific functional questionnaire. It ranges from 23 points (maximum disability) to zero (no disability). A four-point improvement is considered clinically significant.

Results: Data completion was 88%. Median disability improvement was 10 points on the MRQ (p< 0.0001). Benefit occurred in 80% of patients. Although improvements in degenerative spondylolisthesis and isthmic spondylolisthesis were greater than in fusions for discogenic back pain, this was not significant. There was a trend to lesser functional improvements in those receiving compensation (p=0.073) and those who had undergone previous surgery (p=0.068).

Conclusion: This study reports an attempt to audit outcomes in private practice using an instrument applied pre-operatively and at one-year follow-up. The data completion was acceptable. Functional improvements were significant in all diagnositic groups. Outcomes in revision and compensation patients only showed trends to inferior results unlike many other studies.

These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.

None of the authors are receiving any financial benefit or support from any source.