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Thread: Comment about back years after fusion

  1. #16
    Join Date
    Jan 2008
    I agree that the straight dope is likely not known. In the mean time, here's what I found for long term on fusion... emphasis added. N.B. these might be false.
    Here's a 20-30 years follow up

    ABSTRACT: One hundred and ten scoliotic patients
    underwent correction and spine fusion by one of us
    (J. H. M.) at Gillette Children's Hospital between
    1947 and 1957. Sixty-one of these patients were evaluated
    in 1977 for this follow-up study. The evaluation
    consisted of physical and roentgenographic examination,
    photographs, and a detailed psychosocial
    analysis. The aims of the study were to evaluate: (1) the
    long-term stability of the fusion; (2) the incidence and
    severity of low-back pain; and (3) the degree of integration
    of the patient into society.

    The results showed that a solid fusion had no significant
    loss of correction with time. Eighty-four per
    cent of the patients lost only zero to 5 degrees of correction
    during an average follow-up of twenty-six
    years. Low-back pain was found to be no more frequent
    than in the normal population in this age group,
    and there was less low-back pain than in a comparable
    series of scoliotic patients without fusion.

    There was no correlation between the occurrence
    of low-back pain and the length or magnitude of the
    fused curve or the lowest extent of the fusion. An unexpected
    finding was the high incidence of neck pain, the
    cause of which is unknown.
    Psychosocial analysis revealed
    that the patients were productive, active, stable
    persons who were working and contributing members
    of society.
    Here's a review of long term H-rod studies

    Here's some long-term L fusion data from relatively early in the surgical period I think that may be one of the studies to establish the relationship between fusing past L3 and later problems...

    Although patients after lower lumbar fusion report more pain than the general population and have more radiographic evidence of instability and stenosis than expected for the general population, they are generally doing well and are satisfied with the results of their surgery.

    Long term on untreated scoliosis...

    ABSTRACT: Two hundred and nineteen patients
    with untreated adolescent idiopathic scoliosis who were
    seen at the University of Iowa between 1932 and 1948
    were studied, and recent information was available on
    194 of the patients. The mortality rate was 15 per cent.
    Backache was somewhat more common in these patients
    than in the general population, although it was
    never disabling. The backache was unrelated to the
    presence of osteoarthritic changes on roentgenograms.
    Many curves continued to progress slightly in adult
    life, particularly thoracic curves that had reached between
    50 and 80 degrees at skeletal maturity. The lumbar
    components of combined curves between 50 and 74
    degrees also tended to progress. Pulmonary function
    was affected only in patients with thoracic curves.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine

    "We are all African."

  2. #17
    Join Date
    Sep 2007
    Geneseo, NY

    increased disc degeneration and pain

    These quotes are from the Harrington rod study you posted, the group I am in:

    In Danielson and Nachemson's series of patients followed after Harrington instrumentation, they determined that the curves did not increase over time, but that disc degeneration was more common than in a non-operated control group.

    Cochrane7 et al, Hayes et al13 found a high incidence of retrolisthesis in the unfused spine especially when the fusion level was more distal; along with this retrolisthesis, came a higher incidence of back pain.

    Thank you for these references.
    1966 fusion in Buffalo of 11 thoracic vertebrae, with Harrington rod

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