Effects of Lumbar Fusion Instrumentation Removal in Patients Who Experienced Continued Pain After Lumbar Spinal Fusion Surgery for Lumbar Degenerative Disease

Abstract

AIM: To investigate the visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores after the removal of the instrumentation system in patients who underwent lumbar instrumentation for lumbar degenerative disease (LDD).

MATERIAL and METHODS: This study included 30 patients (19 female, 11 male) who had undergone posterior lumbar instrumentation for LDD in whom postoperative continuous or recurrent pain led to the removal of the implant system in our clinic between December 2013 and December 2019. The patients had continuous or recurrent low back pain that did not respond to medical treatment, physical therapy, or any type of lumbar block. Nine patients had continuous low back pain in the surgical area, while twenty-one had recurrent low back pain.

RESULTS: There was a significant reduction in the number of admissions to the hospital (p<0.001), and the daily number of analgesics used (p<0.001) in six months after surgery compared to six months before surgery. There were significant decreases in VAS scores, both at the one-month (p<0.001) and six-month (p<0.001) postoperative assessments compared to preoperative measurements. ODI scores were significantly lower than the preoperative scores at both one-month (p<0.001) and six-month (p<0.001) postoperative score.

CONCLUSION: Our study showed that the instrumentation system removal after fusion for patients with LDD may be beneficial since it alleviates pain and analgesic usage.