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dc.contributor.authorFurunes, Håvard
dc.contributor.authorHellum, Christian
dc.contributor.authorBrox, Jens Ivar
dc.contributor.authorRossvoll, Ivar
dc.contributor.authorEspeland, Ansgar
dc.contributor.authorBerg, Linda
dc.contributor.authorBrøgger, Helga Maria
dc.contributor.authorSmåstuen, Milada C
dc.contributor.authorStorheim, Kjersti
dc.date.accessioned2018-01-18T13:17:14Z
dc.date.available2018-01-18T13:17:14Z
dc.date.created2017-12-07T15:38:10Z
dc.date.issued2017
dc.identifier.citationEuropean spine journal. 2017, .nb_NO
dc.identifier.issn0940-6719
dc.identifier.urihttp://hdl.handle.net/11250/2478166
dc.description.abstractPurpose We aimed to identify patient characteristics associated with favourable long-term outcomes after lumbar total disc replacement (TDR). Methods We analysed a cohort of 82 patients with degenerative disc and chronic low back pain (LBP) who were treated with TDR and originally participated in a randomised trial comparing TDR and multidisciplinary rehabilitation. Potential predictors were measured at baseline, and the outcomes assessed 8 years after they received allocated treatment. Outcome measures were dichotomised according to whether the participants achieved a clinically important functional improvement (15 points or more on the Oswestry Disability Index, ODI) (primary outcome) and whether they were employed at 8-year follow-up (secondary outcome). Associations between potential predictors and outcomes were modelled using logistic regression. For the secondary outcome, the results were also organised in a prediction matrix and expressed as probabilities. Results For 71 patients treated with TDR according to protocol, the follow-up time was 8 years. For a subgroup of 11 patients randomised to rehabilitation who crossed over and received TDR, the median postoperative follow-up time was 72 (range 41–88) months. Of all assessed baseline variables, only presence of Modic changes (type 1 and/or 2) was statistically significantly associated with an improvement of ≥ 15 ODI points. The probability of employment at 8-year follow-up was 1% for patients with ≥ 1 year of sick leave, comorbidity, ODI ≥ 50 and ≤ 9 years of education prior to treatment, and 87% for patients with < 1 year of sick leave, no comorbidity, ODI < 50 and higher education. Conclusions Patients with Modic changes prior to the TDR surgery were more likely to report a clinically important functional improvement at long-term follow-up. Comorbidity, low level of education, long-term sick leave and high ODI score at baseline were associated with unemployment at long-term follow-up.nb_NO
dc.language.isoengnb_NO
dc.publisherSpringer Verlagnb_NO
dc.titleLumbar total disc replacement: predictors for long-term outcomenb_NO
dc.typeJournal articlenb_NO
dc.typePeer reviewednb_NO
dc.description.versionacceptedVersionnb_NO
dc.source.pagenumber1-10nb_NO
dc.source.journalEuropean spine journalnb_NO
dc.identifier.doi10.1007/s00586-017-5375-1
dc.identifier.cristin1524432
dc.description.localcodeThis is a post-peer-review, pre-copyedit version of an article published in [European Spine Journal]. Locked until 4.11.2018 due to copyright restrictions. The final authenticated version is available online at: https://link.springer.com/article/10.1007%2Fs00586-017-5375-1nb_NO
cristin.unitcode194,65,30,0
cristin.unitnameInstitutt for nevromedisin og bevegelsesvitenskap
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode1


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