Utility of spine surgery: a comparison of common elective orthopaedic surgical procedures

Spine (Phila Pa 1976). 2008 Dec 1;33(25):2819-30. doi: 10.1097/BRS.0b013e31818e2914.


Study design: A 1-year prospective observational cohort study.

Objective: To compare the utility before and 1 year after elective spine surgery with some other common orthopaedic surgical procedures.

Summary of background data: By using global measures like EQ-5D and SF-36 for the determination of the utility, the changes in quality of life, quality of life (QoL) after an intervention different diagnoses, and treatments can be compared. Total hip replacement (THR) has become almost golden standard in this respect.

Methods: Seven hundred seventy-seven subjects with different common orthopaedic diagnoses scheduled for elective surgery were just before surgery and 1 year after surgery answering both EQ-5D and SF-36. Four groups with different spine diagnoses and procedures were formed and compared with 8 other diagnoses and treatment groups.

Results: Before surgery, subjects with spine diagnoses reported the lowest QoL of all diagnoses compared. Surgery for spinal stenosis, spondylolisthesis, and instability meant the largest improvement of all surgical interventions. Surgery for NHP gave a moderately good improvement, whereas surgery for CLBP only marginally improved those operated. Particularly THR but also TKR more or less completely normalized QoL but made it from a relatively high preoperative level. The greatest improvements after spine surgery, other surgical procedures, and different diagnoses were in the pain/discomfort domain.

Conclusion: Spinal surgery in spinal stenosis, spondylolisthesis, and instability had in comparison to other types of elective orthopaedic surgery an outstanding better ability to improve the operated subject's health-related quality of life than other types of elective orthopaedic surgery. The utility of HNP surgery was somewhat lower and was rather marginal for those operated for nonspecific CLBP.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Diagnosis, Differential
  • Elective Surgical Procedures / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Low Back Pain / diagnosis
  • Low Back Pain / psychology
  • Low Back Pain / surgery
  • Male
  • Middle Aged
  • Orthopedic Procedures / statistics & numerical data*
  • Prospective Studies
  • Quality of Life / psychology
  • Spinal Diseases / diagnosis
  • Spinal Diseases / psychology
  • Spinal Diseases / surgery*
  • Young Adult