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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.accessioned2018-11-09T12:22:28Z
dc.date.available2018-11-09T12:22:28Z
dc.date.issued2017-11-04
dc.description.abstractPurpose: We aimed to identify patient characteristics associated with favourable long-term outcomes after lumbar total disc replacement (TDR). <br>Methods: We analysed a cohort of 82 patients with degenerative disc and chronic low back pain (LBP) who were treatedwith 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. <br>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 signifcantly 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. <br>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.en_US
dc.identifier.citationFurunes, H., Hellum, C., Brox, J.I., Rossvoll, I., Espeland, A., Berg, L., ... Storheim K. (2017). Lumbar total disc replacement: predictors for long-term outcome. European spine journal, 27, Issue 3, 709–718. https://doi.org/10.1007/s00586-017-5375-1en_US
dc.identifier.cristinIDFRIDAID 1524432
dc.identifier.doi10.1007/s00586-017-5375-1
dc.identifier.issn0940-6719
dc.identifier.urihttps://hdl.handle.net/10037/14150
dc.language.isoengen_US
dc.publisherSpringer Natureen_US
dc.relation.journalEuropean spine journal
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medical disciplines: 700::Clinical medical disciplines: 750en_US
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750en_US
dc.subjectLow back painen_US
dc.subjectDegenerative discen_US
dc.subjectLumbar total disc replacementen_US
dc.subjectPatient selectionen_US
dc.titleLumbar total disc replacement: predictors for long-term outcomeen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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