QUALITY OF LIFE ANALYSIS ON PATIENTS AFTER ARTHROPLASTY OR LUMBAR ARTHRODESIS

ABSTRACT Objective: To perform a retrospective analysis of patients with degenerative disc disease of the lumbar spine undergoing arthrodesis or lumbar arthroplasty in terms of functional capacity and quality of life. Methods: Retrospective observational study analyzing the medical records of patients undergoing arthrodesis or lumbar arthroplasty, followed-up at an outpatient clinic from 2018 to 2020. Patient characteristics were evaluated; the quality of life through the results of the Short Form 36 Health Survey Questionnaire (SF-36) and the functional capacity using the Oswestry Disability Index (ODI) in the pre-surgical and post-surgical periods (6 months, 1 and 2 years). The criterion to establish statistical significance was p≤0.05. Results: Sixty-one patients were evaluated. After the surgical interventions, the individuals migrated from the classification of invalid (61.4%-64.6%) to minimal/moderate disability (17.7%-25.6%). There was a decline in ODI scores over time of follow-up (p≤0.001) as well as in SF-36 values (p≤0.001) for all surgical techniques. In this regard, evaluating the difference in means revealed the better performance of lumbar arthroplasty (p≤0.001). Conclusion: The data suggest that lumbar arthroplasty offers greater benefits to patients regarding functional capacity and quality of life. Level of Evidence III; Retrospective, descriptive, observational study.

【摘要】
目的：针对接受脊柱融合术或腰椎关节成形术的腰椎退行性椎间盘疾病患者，从功能状态与生活质量维度开展回顾性分析。
方法：本研究为回顾性观察性研究，分析2018至2020年于门诊接受随访的接受脊柱融合术或腰椎关节成形术患者的病历资料。研究评估了患者基线特征；术前及术后6个月、1年、2年时，采用简明健康状况调查问卷（Short Form 36 Health Survey Questionnaire, SF-36）评估患者生活质量，利用奥斯韦斯特里功能障碍指数（Oswestry Disability Index, ODI）评价其功能状态。本研究设定的统计学显著性判定标准为p≤0.05。
结果：本研究共纳入61例患者完成分析。术后患者的功能分级从术前的失能（占比61.4%~64.6%）转变为轻度/中度功能障碍（占比17.7%~25.6%）。两种手术方式下，患者的ODI评分随随访时间延长显著降低（p≤0.001），SF-36评分亦显著升高（p≤0.001）。进一步的组间均值差异分析显示，腰椎关节成形术的临床效果更优（p≤0.001）。
结论：本研究数据表明，腰椎关节成形术可更显著地改善腰椎退行性椎间盘疾病患者的功能状态与生活质量。本研究证据等级为III级，属于回顾性描述性观察研究。