Artikel
Sports after lumbar spondylodesis
Sportfähigkeit nach lumbaler Spondylodese
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Autoren
Veröffentlicht: | 23. April 2004 |
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Gliederung
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Objective
Lumbar spondylodesis is a common surgical procedure to treat primary or secondary unstable and painful segments of the lumbar spine. The clinical results are well studied concerning various outcome scores. But there are only very few published studies in the literature describing the sports ability and activity before and after fusion.
Methods
We studied retrospectively the pre- and postoperative sports activity of 55 patients, who underwent a posterolateral lumbar fusion with autologous bone graft and VSP (Steffee) instrumentation. There were 24 men and 31 women with a mean age of 54, 6 years (32 to 76) at the time of surgery. Diagnosis leading to surgical treatment was without exception a degenerative disease of the lumbar spine. All patients had spinal stenosis and instability, 71% in combination with degenerative spondylolisthesis and in 17% in combination with a disk prolaps. 37 patients had a fusion at one level, 18 a multi-level fusion. In addition to the fusion 9 patients had a combination with diskectomy and 37 of posterior decompression. All patients practiced sports at a recreational level, 25% less than a half hour (group1), 57% less (group2) and 18% more than 1½ hours (group3) per week, with an average of 1 hour. Most popular activities were biking (73%), swimming (40%), walking (29%) and skiing (20%). With the help of verbal interviews and questionnaires we can overlook a 5-year postoperative interval of sports activity.
Results
Two- and 5-year postoperative evaluations of the group were the database for our results. Significant (p< 0,001) postoperative remission of pain was more than 50% (from 9.5 to 4,2 in the VAS) after 2 years and stayed constant for the following years. Within the 2-year interval 45% returned to endurance sports and 33% to training with weights. Describing the 5-year outcome, the number of patients with an average sports activity of 1 hour (group2) stayed almost constant with 57%. There were less persons in group 3 (7%) and more in group 1 (38%). The self-assessment of the ability to practice sport was positive in 42% after operation, in contrast to 5% before operation. The reason to reduce the intensity of their training for 40% of the patients without complaints was the fear of risking their good clinical outcome.
Conclusions
At the present time, there are no reports published in the literature concerning recreational sports activities of patients, who had undergone lumbar fusion. We can demonstrate that postoperative sport is possible without negative influence on the 5-year outcome. It is important to modify the physical activities in such a way as to avoid a negative influence on the unfused lumbar segments that could lead to the so-called adjacent level disease.