Article

The rise in the number of patients with lumbar back pain has led to
an increase in the number of spinal surgeries. To avoid unfavorable outcomes,
high accuracy and reliability of indication for surgery are essential. This
requires critical evaluation of postoperative outcomes with its two key
dimensions pain and function. While imaging findings give details about the
technical dimension of the intervention, they are prone to high
inter-/intra-observer variability, with limited relation to functional outcomes.
Pain improvement can be directly asked from patients or documented by
questionnaires. There is abundant literature on postoperative function based on
questionnaires, but quantifiable data such as gait or posture analysis are
scarce. Highprecision measurement tools are available and easy to implement in a
clinician's work routine. OBJECTIVE: This study evaluates whether lumbar fusion
surgery changes gait and postural variables and how these changes are related to
patients' descriptions of alterations in their levels of pain. METHODS: Back
profiles and gait analyses were measured by video rasterstereography and
treadmill gait analysis. Measurements were recorded before surgery, at discharge,
after 3 months in a longitudinal (n=30), and after 12 months in a cross-sectional
group (n=29). A reference group was formed (n=28). The improvement on the Numeric
Pain Rating Scale was documented and compared with changes in gait and posture.
RESULTS: A significant reduction in kyphotic (52-43 degrees , p=0.014) and
lordotic (28-11 degrees , p<0.001) angles was observed. The values again
increased after 3 months, with a significant reduction in cadence (98-91
steps/min, p=0.006). While improvements in pain were also obtained by surgery
(p<0.001), no clear correlation could be detected between 3-month alleviation in
pain and changes in kyphotic/lordotic angle or cadence.
CONCLUSIONS: Although
both methods offer high-precision measurement, changes in gait and posture were
not related with the patients' reported pain relief after lumbar fusion surgery.
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Langue : ANGLAIS