Laminectomy and extension of instrumented fusion improves 2-year pain, disability, and quality of life in patients with adjacent segment disease: Defining the long-term effectiveness of surgery

Owoicho Adogwa; Scott L. Parker; Stephen K. Mendenhall; David N. Shau; Oran Aaronson; Joseph Cheng; Clinton J. Devin; Matthew J. McGirt

doi:10.1016/j.wneu.2011.12.082

Laminectomy and extension of instrumented fusion improves 2-year pain, disability, and quality of life in patients with adjacent segment disease: Defining the long-term effectiveness of surgery

Owoicho Adogwa, Scott L. Parker, Stephen K. Mendenhall, David N. Shau, Oran Aaronson, Joseph Cheng, Clinton J. Devin, Matthew J. McGirt

Research output: Contribution to journal › Review article › peer-review

4 Scopus citations

Abstract

Objective: Adjacent segment disease (ASD) may occur as a long-term consequence of spinal fusion and is associated with significant back and leg pain. Surgical management of symptomatic ASD consists of neural decompression and extension of fusion. However, conflicting results have been reported with respect to the long-term clinical effectiveness of revision surgery in this setting. We set out to comprehensively assess the long-term clinical outcome after revision surgery and determine its effectiveness in the treatment of adjacent segment disease. Methods: Fifty patients undergoing revision surgery for ASD-associated back and leg pain were included in this study. Baseline and 2-year Visual Analog Scale-Back Pain (VAS-BP), Visual Analog Scale-Leg Pain (VAS-LP), Oswestry Disability Index, physical and mental quality of life (Short Form-12 [SF-12] physical and mental component score [PCS and MCS]) and health-state utility (EuroQol [EQ-5D]) were assessed. Results: A sustained improvement in VAS-BP (8.72 ± 1.85 vs. 3.92 ± 2.84, P = 0.001), VAS-LP (6.30 ± 3.90 vs. 3.02 ± 3.03, P = 0.001), Oswestry Disability Index (28.72 ± 9.64 vs. 18.48 ± 11.31, P = 0.001), SF-12 PCS (26.89 ± 8.85 vs. 35.58 ± 11.97, P = 0.001) and SF-12 MCS (44.66 ± 12.85 vs. 53.16 ± 9.46, P = 0.001) was observed 2 years after revision surgery, with a cumulative mean 2-year gain of 0.76 quality-adjusted life-years (EQ-5D). Median (interquartile range) time to narcotic independence and return to work was 1.7 (1.0-8.0) months and 2.0 (1.0-4.75) months, respectively. Conclusions: Patients undergoing decompression and extension of fusion for adjacent segment disease-associated back and leg pain reported long-term improvement in pain, disability, and both physical and mental quality of life, suggesting that revision surgery is a highly effective treatment strategy in this patient population.

Original language	English (US)
Pages (from-to)	893-896
Number of pages	4
Journal	World neurosurgery
Volume	80
Issue number	6
DOIs	https://doi.org/10.1016/j.wneu.2011.12.082
State	Published - Dec 2013
Externally published	Yes

Keywords

Adjacent segment disease
Fusion
Laminectomy
Quality of life

ASJC Scopus subject areas

Surgery
Clinical Neurology

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10.1016/j.wneu.2011.12.082

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Adogwa, O., Parker, S. L., Mendenhall, S. K., Shau, D. N., Aaronson, O., Cheng, J., Devin, C. J., & McGirt, M. J. (2013). Laminectomy and extension of instrumented fusion improves 2-year pain, disability, and quality of life in patients with adjacent segment disease: Defining the long-term effectiveness of surgery. World neurosurgery, 80(6), 893-896. https://doi.org/10.1016/j.wneu.2011.12.082

Laminectomy and extension of instrumented fusion improves 2-year pain, disability, and quality of life in patients with adjacent segment disease: Defining the long-term effectiveness of surgery. / Adogwa, Owoicho; Parker, Scott L.; Mendenhall, Stephen K. et al.
In: World neurosurgery, Vol. 80, No. 6, 12.2013, p. 893-896.

Research output: Contribution to journal › Review article › peer-review

Adogwa, O, Parker, SL, Mendenhall, SK, Shau, DN, Aaronson, O, Cheng, J, Devin, CJ & McGirt, MJ 2013, 'Laminectomy and extension of instrumented fusion improves 2-year pain, disability, and quality of life in patients with adjacent segment disease: Defining the long-term effectiveness of surgery', World neurosurgery, vol. 80, no. 6, pp. 893-896. https://doi.org/10.1016/j.wneu.2011.12.082

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title = "Laminectomy and extension of instrumented fusion improves 2-year pain, disability, and quality of life in patients with adjacent segment disease: Defining the long-term effectiveness of surgery",

abstract = "Objective: Adjacent segment disease (ASD) may occur as a long-term consequence of spinal fusion and is associated with significant back and leg pain. Surgical management of symptomatic ASD consists of neural decompression and extension of fusion. However, conflicting results have been reported with respect to the long-term clinical effectiveness of revision surgery in this setting. We set out to comprehensively assess the long-term clinical outcome after revision surgery and determine its effectiveness in the treatment of adjacent segment disease. Methods: Fifty patients undergoing revision surgery for ASD-associated back and leg pain were included in this study. Baseline and 2-year Visual Analog Scale-Back Pain (VAS-BP), Visual Analog Scale-Leg Pain (VAS-LP), Oswestry Disability Index, physical and mental quality of life (Short Form-12 [SF-12] physical and mental component score [PCS and MCS]) and health-state utility (EuroQol [EQ-5D]) were assessed. Results: A sustained improvement in VAS-BP (8.72 ± 1.85 vs. 3.92 ± 2.84, P = 0.001), VAS-LP (6.30 ± 3.90 vs. 3.02 ± 3.03, P = 0.001), Oswestry Disability Index (28.72 ± 9.64 vs. 18.48 ± 11.31, P = 0.001), SF-12 PCS (26.89 ± 8.85 vs. 35.58 ± 11.97, P = 0.001) and SF-12 MCS (44.66 ± 12.85 vs. 53.16 ± 9.46, P = 0.001) was observed 2 years after revision surgery, with a cumulative mean 2-year gain of 0.76 quality-adjusted life-years (EQ-5D). Median (interquartile range) time to narcotic independence and return to work was 1.7 (1.0-8.0) months and 2.0 (1.0-4.75) months, respectively. Conclusions: Patients undergoing decompression and extension of fusion for adjacent segment disease-associated back and leg pain reported long-term improvement in pain, disability, and both physical and mental quality of life, suggesting that revision surgery is a highly effective treatment strategy in this patient population.",

keywords = "Adjacent segment disease, Fusion, Laminectomy, Quality of life",

author = "Owoicho Adogwa and Parker, {Scott L.} and Mendenhall, {Stephen K.} and Shau, {David N.} and Oran Aaronson and Joseph Cheng and Devin, {Clinton J.} and McGirt, {Matthew J.}",

year = "2013",

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doi = "10.1016/j.wneu.2011.12.082",

language = "English (US)",

volume = "80",

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T1 - Laminectomy and extension of instrumented fusion improves 2-year pain, disability, and quality of life in patients with adjacent segment disease

T2 - Defining the long-term effectiveness of surgery

AU - Adogwa, Owoicho

AU - Parker, Scott L.

AU - Mendenhall, Stephen K.

AU - Shau, David N.

AU - Aaronson, Oran

AU - Cheng, Joseph

AU - Devin, Clinton J.

AU - McGirt, Matthew J.

PY - 2013/12

Y1 - 2013/12

N2 - Objective: Adjacent segment disease (ASD) may occur as a long-term consequence of spinal fusion and is associated with significant back and leg pain. Surgical management of symptomatic ASD consists of neural decompression and extension of fusion. However, conflicting results have been reported with respect to the long-term clinical effectiveness of revision surgery in this setting. We set out to comprehensively assess the long-term clinical outcome after revision surgery and determine its effectiveness in the treatment of adjacent segment disease. Methods: Fifty patients undergoing revision surgery for ASD-associated back and leg pain were included in this study. Baseline and 2-year Visual Analog Scale-Back Pain (VAS-BP), Visual Analog Scale-Leg Pain (VAS-LP), Oswestry Disability Index, physical and mental quality of life (Short Form-12 [SF-12] physical and mental component score [PCS and MCS]) and health-state utility (EuroQol [EQ-5D]) were assessed. Results: A sustained improvement in VAS-BP (8.72 ± 1.85 vs. 3.92 ± 2.84, P = 0.001), VAS-LP (6.30 ± 3.90 vs. 3.02 ± 3.03, P = 0.001), Oswestry Disability Index (28.72 ± 9.64 vs. 18.48 ± 11.31, P = 0.001), SF-12 PCS (26.89 ± 8.85 vs. 35.58 ± 11.97, P = 0.001) and SF-12 MCS (44.66 ± 12.85 vs. 53.16 ± 9.46, P = 0.001) was observed 2 years after revision surgery, with a cumulative mean 2-year gain of 0.76 quality-adjusted life-years (EQ-5D). Median (interquartile range) time to narcotic independence and return to work was 1.7 (1.0-8.0) months and 2.0 (1.0-4.75) months, respectively. Conclusions: Patients undergoing decompression and extension of fusion for adjacent segment disease-associated back and leg pain reported long-term improvement in pain, disability, and both physical and mental quality of life, suggesting that revision surgery is a highly effective treatment strategy in this patient population.

AB - Objective: Adjacent segment disease (ASD) may occur as a long-term consequence of spinal fusion and is associated with significant back and leg pain. Surgical management of symptomatic ASD consists of neural decompression and extension of fusion. However, conflicting results have been reported with respect to the long-term clinical effectiveness of revision surgery in this setting. We set out to comprehensively assess the long-term clinical outcome after revision surgery and determine its effectiveness in the treatment of adjacent segment disease. Methods: Fifty patients undergoing revision surgery for ASD-associated back and leg pain were included in this study. Baseline and 2-year Visual Analog Scale-Back Pain (VAS-BP), Visual Analog Scale-Leg Pain (VAS-LP), Oswestry Disability Index, physical and mental quality of life (Short Form-12 [SF-12] physical and mental component score [PCS and MCS]) and health-state utility (EuroQol [EQ-5D]) were assessed. Results: A sustained improvement in VAS-BP (8.72 ± 1.85 vs. 3.92 ± 2.84, P = 0.001), VAS-LP (6.30 ± 3.90 vs. 3.02 ± 3.03, P = 0.001), Oswestry Disability Index (28.72 ± 9.64 vs. 18.48 ± 11.31, P = 0.001), SF-12 PCS (26.89 ± 8.85 vs. 35.58 ± 11.97, P = 0.001) and SF-12 MCS (44.66 ± 12.85 vs. 53.16 ± 9.46, P = 0.001) was observed 2 years after revision surgery, with a cumulative mean 2-year gain of 0.76 quality-adjusted life-years (EQ-5D). Median (interquartile range) time to narcotic independence and return to work was 1.7 (1.0-8.0) months and 2.0 (1.0-4.75) months, respectively. Conclusions: Patients undergoing decompression and extension of fusion for adjacent segment disease-associated back and leg pain reported long-term improvement in pain, disability, and both physical and mental quality of life, suggesting that revision surgery is a highly effective treatment strategy in this patient population.

KW - Adjacent segment disease

KW - Fusion

KW - Laminectomy

KW - Quality of life

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Laminectomy and extension of instrumented fusion improves 2-year pain, disability, and quality of life in patients with adjacent segment disease: Defining the long-term effectiveness of surgery

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Keywords

ASJC Scopus subject areas

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