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Self-Image and Health-Related Quality of Life Three Decades After Fusion In Situ for High-Grade Isthmic Spondylolisthesis
Örebro University, School of Medical Sciences. Department of Orthopaedics, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0002-7931-9617
Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Department of Orthopaedics, Karolinska University Hospital, Stockholm, Sweden.
Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Department of Orthopaedics, Karolinska University Hospital, Stockholm, Sweden.
Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg and Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden.
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2019 (English)In: Spine deformity, ISSN 2212-134X, Vol. 7, no 2, p. 293-297Article in journal (Refereed) Published
Abstract [en]

STUDY DESIGN: Observational study.

OBJECTIVES: To evaluate self-image after in situ fusion for high-grade isthmic spondylolisthesis.

SUMMARY OF BACKGROUND DATA: Certain clinical findings such as short trunk or waistline skin folds are often seen in high-grade spondylolisthesis. Since treatment with spinal fusion in situ does not address appearance, self-image and also health-related quality of life might be negatively affected in the short-term as well as the long-term perspective. This observational study evaluated health-related quality of life outcome including self-image three decades after in situ fusion for high-grade isthmic spondylolisthesis in relation to healthy controls.

METHODS: Thirty-eight of 39 consecutive patients, fused in situ for high-grade isthmic spondylolisthesis at a young age, completed the Scoliosis Research Society (SRS)-22r questionnaire 28-41 years after surgery. The results were compared with the results of an age- and gender-matched control group.

RESULTS: We found that the SRS-22r self-image domain scores were statistically significantly lower in patients than in controls whereas the pain and mental health scores were similar in patients and controls. Also, the SRS-22r function domain scores were statistically significantly lower in patients but the difference in means was small. We found no correlation between severity of slip and SRS-22r outcome.

CONCLUSIONS: In situ fusion for high-grade isthmic spondylolisthesis is a safe treatment option in the long term from a function and pain perspective, but the results of our study suggest that self-image is negatively affected long into adult life.

LEVEL OF EVIDENCE: Level IV.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 7, no 2, p. 293-297
Keywords [en]
Fusion in situ, Health-related quality of life, SRS-22r, Self-image, Spondylolisthesis
National Category
Orthopaedics
Identifiers
URN: urn:nbn:se:oru:diva-71913DOI: 10.1016/j.jspd.2018.08.012ISI: 000671879700015PubMedID: 30660224Scopus ID: 2-s2.0-85054010418OAI: oai:DiVA.org:oru-71913DiVA, id: diva2:1283775
Available from: 2019-01-29 Created: 2019-01-29 Last updated: 2021-12-30Bibliographically approved
In thesis
1. High-grade spondylolisthesis in young patients: Long-term results of in situ fusion
Open this publication in new window or tab >>High-grade spondylolisthesis in young patients: Long-term results of in situ fusion
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The purpose of this long-term follow-up of 38 of 40 consecutive patients was to evaluate the results of uninstrumented in situ fusion for high-grade isthmic spondylolisthesis three decades after surgery. The mean age at surgery was 14 (range 9-24) years. The first of four studies evaluated clinical outcome, function, work status, and health-related quality of life (HRQoL) after in situ fusion in relation to age-matched Swedish population data. The second study evaluated effects on sagittal balance after in situ fusion. The third study evaluated adjacent segment disk degeneration after in situ fusion. The fourth study evaluated self-imageand HRQoL after in situ fusion in relation to healthy controls.

The main findings were that (1) young patients fused in situ for highgrade isthmic spondylolisthesis have long-term HRQoL similar to the general Swedish population and controls matched for age and gender, (2) signs of non-compensated sagittal imbalance were observed only ina few individuals whereas compensated sagittal balance was the norm, (3) there was no correlation between any radiographic sagittal balance parameter and HRQoL outcome, (4) there was only a minor reduction inadjacent segment disk height which had no impact on HRQoL outcome, and (5) the only patient reported outcome measure indicating a detrimental effect at long-term follow-up was self-assessed trunk appearance which was slightly negatively affected.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2020. p. 63
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 205
Keywords
Adjacent segment disk degeneration, Fusion in situ, Health-related quality of life, Sagittal balance, Self-image, Spondylolisthesis
National Category
Surgery
Identifiers
urn:nbn:se:oru:diva-78541 (URN)978-91-7529-291-5 (ISBN)
Public defence
2020-02-14, Örebro universitet, Campus USÖ, hörsal C3, Södra Grev Rosengatan 32, Örebro, 09:00 (Swedish)
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Available from: 2019-12-10 Created: 2019-12-10 Last updated: 2020-02-21Bibliographically approved

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Joelson, AndersWretenberg, Per

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