SENSE OF COHERENCE AND OUTCOME OF ANTERIOR LOW-BACK FUSION - A 5-YEARTO 13-YEAR FOLLOW-UP OF 85 PATIENTS

Eighty-five patients were followed up for more than 5 years after an a nterior low-back fusion which was performed for a chronically painful low-back condition. The mean age of the patients at the time of the in dex operation was 35 years, the mean duration of their symptoms was 8 years, and 50 (59%) had undergone previous low-back surgery. Preoperat ively the patients were on average severely disabled according to the Oswestry scale, and the self-rated improvement at the follow-up on ave rage 7.4 years after surgery was significant, the mean index being 24% . In 29 (34%) patients, the Oswestry index was 10% or below, reflectin g none or very little discomfort as a result of the surgery. In all ag e groups, women had better results than men. The best outcome was foun d in patients with no previous low-back surgery. Half of the patients returned to work. Thirteen patients needed new surgery because of nonu nion. The use of transpedicular fixation did not produce better result s. The sense of coherence scale assessing the patient's successful cop ing capability had a very good predictive value in the whole series, a nd this predictive value was especially good in patients between 35 an d 50 years of age. Also, the shorter duration of symptoms was an impor tant predictor of a successful outcome, and the end results in patient s who had a longer duration of preoperative low-back symptoms tended t o be poor.