Quality of Life after Multisegmental Fusion Surgery for Degenerative Spine Diseases

Frank Beyer; Johanna Schirmer; Tobias Prasse; Peer Eysel; Jan Bredow

doi:10.1055/a-2546-7316

Zeitschrift für Orthopädie und Unfallchirurgie, Table of Contents

Z Orthop Unfall 2025; 163(05): 458-467
DOI: 10.1055/a-2546-7316

Review

Quality of Life after Multisegmental Fusion Surgery for Degenerative Spine Diseases

Article in several languages: English | deutsch

Authors

Frank Beyer

¹Klinik für Orthopädie und Unfallchirurgie, Krankenhaus Porz am Rhein gGmbH, Köln, Germany (Ringgold ID: RIN39825)
Johanna Schirmer

²Medizinische Fakultät, Universität zu Köln, Köln, Germany (Ringgold ID: RIN61059)
Tobias Prasse

³Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastisch-Ästhetische Chirurgie, Uniklinik Köln, Köln, Germany (Ringgold ID: RIN249152)
Peer Eysel

³Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastisch-Ästhetische Chirurgie, Uniklinik Köln, Köln, Germany (Ringgold ID: RIN249152)
Jan Bredow

¹Klinik für Orthopädie und Unfallchirurgie, Krankenhaus Porz am Rhein gGmbH, Köln, Germany (Ringgold ID: RIN39825)

Abstract

Background

Degenerative spinal diseases may lead to multisegmental instabilities and present as de novo scoliosis. Due to frequent primary and secondary complications, their treatment is controversial among spine surgeons. The aim of this systematic review is to investigate the postoperative quality of life after multilevel fusion surgery for de novo scoliosis. Furthermore, technical aspects and complications are examined in detail.

Methods

A systematic literature search was conducted, excluding systematic reviews or meta-analyses. A follow-up period of at least 24 months was required. Standardised outcome instruments on quality of life, epidemiological data and information on surgical technique and any further follow-up examinations were extracted. Studies on adolescents or neuromuscular scoliosis were excluded, as were case reports and studies on short-span fusions.

Results

Twenty studies were included in the systematic review. The Oswestry Disability Index (ODI) was reported in 15 studies. All authors reported significant improvements. Inclusion of the L5/S1 segment showed no differences in quality of life, but better radiological correction, although the rate of adjacent segment degeneration and complications was higher. The data on general postoperative complications ranged from 10.5% to 71.5%.

Conclusions

Quality of life after multilevel fusion for de novo scoliosis shows significant improvements. There is no general recommendation on the last instrumented vertebra or the caudal anchoring of the instrumentation. Treatment in specialised centres for spine surgery is strongly recommended, also due to the high postoperative complication rates.

Keywords

de-novo scoliosis - quality of life - multilevel fusion - last instrumented vertebra - adjacent segment degeneration

Full Text

References

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