Predicting Quality of Life After Lumbar Spondylodesis

Quality of life after spondylodesis was predicted by pretreatment psychological variables and findings in a standardized physical examination. Four quality-of-life criteria were used: functional capacity, vocational rehabilitation, satisfaction with the outcome of the operation, and pain intensity recorded in a pain diary. Those of six presurgery variables that proved to be associated with the outcome 9 months postsurgery, by means of a multiple stepwise regression procedure, were selected for discriminant analyses. The sample consisted of 50 consecutive patients who underwent either ventral (n = 10) or posterolateral (n = 40) spondylodesis with or without posterior instrumentation. Their average age was 44.9 years (SD = 12.9) with an average duration of pain of 8.6 years (SD = 8.8). Nearly half of the patients had had previous spine surgery. Follow-up data indicate that about half of the patients show a beneficial outcome in terms of quality-of-life measures. Discriminant analyses suggest that poor presurgical functional capacity and an unclear finding in the physical examination before surgery contribute to our knowledge about patients who are likely to show continuous pain and poor functional capacity after surgery.