Generalized joint laxity at baseline does not affect fusion rate or clinical outcomes

by / Wednesday, 16 December 2015 /

According to findings in a recently published study, generalized joint laxity has little effect on fusion rates or the clinical outcomes of pain intensity and functional status, but it may have a negative effect on adjacent segment pathology after posterior lumbar interbody fusion.

Researchers conducted a retrospective comparative study that included 37 patients with generalized joint laxity (GJL) and 219 patients without GJL. The two groups were followed for 2 years after undergoing posterior lumbar interbody fusion (PLIF), with the researchers comparing fusion rates, low back pain intensity on a VAS and functional outcome based on the Oswestry Disability Index (ODI) between the two groups.

Two years after surgery, 91.9% of patients with GJL and 91.8% of patients without GJL experienced successful fusion, according to radiographic images in the study.

Both groups experienced significant decreases in VAS scores for low back pain, with improvements in pain intensity of 75.1% for the GJL group and 77.9% in the non-GJL group; however, the difference between the groups for low back pain, as well as the difference between the groups for ODI score, was not considered statistically significant, according to the researchers.

The researchers observed adjacent segment pathology to be present in both the superior and inferior segments within both groups, but this was also not considered to be significantly different between the two groups.

Patients in the GJL group were observed to have a greater degree of severe degeneration based on modified Pfirrmann classification compared with patients without GJL, which was considered a statistically significant difference, according to the researchers.

The researchers concluded that although GJL may contribute to the worsening or loosening of adjacent segment pathology, GJL at baseline does not affect fusion rates or clinical outcomes.

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