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Órgano Oficial de difusión científica de la Asociación Mexicana de Cirujanos de Columna A. C.

2025, Number 1

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Cir Columna 2025; 3 (1)

Functional assessment of postoperative patients undergoing posterolateral fusion L4-S1 at the General Regional Hospital No.1

Márquez CCJ, Méndez CEA

Language: Spanish
References: 28
Page: 23-30
PDF size: 242.17 Kb.


ABSTRACT

Introduction: lumbar stenosis encompasses a wide range of conditions that lead to medical attention at the primary and secondary levels of the Mexican Institute of Social Security. Furthermore, we must consider that a significant portion of these patients will eventually require spinal surgery if they do not respond to an initial conservative treatment, which ideally should be administered for at least six months. The Oswestry Disability Index (ODI) assesses the functional limitation of patients with spinal pathology and is considered the reference method for diagnosing lower back functionality. Furthermore, it has predictive value for the chronicity of pain and the outcomes of both conservative and surgical treatments Objective: to evaluate the clinical and functional evolution of patients with lumbar stenosis postoperatively undergoing posterolateral fusion 4-S1 at the General Regional Hospital No. 1. Material and methods: sixty-six patients diagnosed with lumbar spinal stenosis who underwent 4-S1 posterolateral fusion were assessed using the Oswestry questionnaire before the surgical intervention and one month afterward. This evaluation measured the degree of disability before and after the spinal surgery. Additionally, epidemiological data will be collected, including age, occupation (and work disability if applicable), risk factors (smoking, body mass index), comorbidities, as well as previous treatments and their duration. Results: The mean age was 52 years, with a predominance of male patients and an average BMI of 29 kg/m². The primary reason for surgery was low back pain, with an average duration of 3.8 years. Only three patients had undergone rehabilitation before the intervention, and 35 patients were on work-related disability at the time of surgery. Before the intervention, most patients presented limitations in daily and occupational activities as measured by the Oswestry Index. Following surgery, moderate disability was the most frequently observed outcome. A total of 82% of patients showed improvement. Conclusions: posterolateral fusion appears to be a treatment that offers significant improvement in functionality and pain relief for patients with lumbar spinal stenosis. The variability in treatment response suggests that individualized strategies should be considered for each patient.


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