Byung Joon Shin

Analysis of Risk Factors for Adjacent Segment Degeneration Occurring More than 5 Years after Fusion with Pedicle Screw Fixation for Degenerative Lumbar Spine

Study Design A retrospective study. Purpose We investigated the risk factors in adjacent segment degeneration (ASD) after more than 5 years of follow-up of lumbar spinal fusion. Overview of Literature There are many concerns regarding ASD followed by lumbar spinal fusion. However, there is a great deal of dispute about the risk factors. Methods A total of 55 patients who were followed up for more than 5 years after lumbar fusion were observed. Gender, age, residence, fusion method, number of fusion segments and radiological measurements were analyzed. In the radiological measurement, disc height, lumbar lordotic angle (LLA), fusion segment lordotic angle and fusion segment lordotic angle per level (FSLA per level) were estimated. In preoperative MRI, Pfirrmanns classification was used. The clinical result was evaluated by the criteria of Kim and Kim. Statistical univariate analysis was performed with the chi-square test by using SPSS ver. 12.0. Multivariate logistic regression analysis was conducted with SAS ver. 9. Results There were 21 patients with adjacent segment degeneration. Further, there was little relationship between ASD and gender, age, residence, fusion method, number of fusion segments, degree of preoperative adjacent disc degeneration in MRI, or preoperative and postoperative LLA. However, the frequency of ASD was significantly low in cases where FSLA per level was >15° (p=0.009). There was no significant relationship between ASD and the clinical result. Conclusions In patients followed up for more than 5 years after lumbar spinal fusion, the most important factor in the prevention of ASD was the restoration of FSLA per level to >15°.

How Does Chronic Back Pain Influence Quality of Life in Koreans: A Cross-Sectional Study

Study Design A cross-sectional study. Purpose To explore the impact of chronic low back pain (CLBP) on individuals quality of life; to understand current treatment practices and level of satisfaction with treatment in patients with CLBP. Overview of Literature Assessing subjective, patient-reported outcomes such as quality of life is essential to health care research. Methods Influences of the CLBP were analyzed via a questionnaire, which contained the character of CLBP, effect of pain management, Korean version Oswestry Disability Index (K-ODI) and Korean version of 12-item Short Form Health Survey (SF-12v2). Results Of 3,121 subjects who responded, 67.3% had moderate to severe pain; 43.5% presented prolonged CLBP of more than two years; and 32.4% had suffered from sleep disturbance due to pain. 22.8% of the patients were not satisfied with current pain management. The mean K-ODI score was 37.63; and it was positively correlated with the mean pain intensity (r=0.6, p<0.001). The SF-12v2 result was negatively correlated with mean pain intensity (PCS: r=-0.5, p<0.001; MCS: r=-0.4, p<0.001) and also negatively correlated with the K-ODI score (PCS: r=-0.75, p<0.001; MCS: r=-0.5, p<0.001). The conformity between patients and doctors in pain assessment was fair (κ=0.2463). Conclusions CLBP negatively affects quality of life. Of total 22.8% of the patients were not satisfied with current pain management. Such needs to be taken more seriously by doctors for improvement of satisfaction and quality of life in patients with CLBP.