Disc Height and Sagittal Alignment in Operated and Non-Operated Levels in the Lumbar Spine at Long-Term Follow-Up: A Case-Control Study

Anne Froholdt*, 1, 2, Jens Ivar Brox1, Olav Reikerås1, Gunnar Leivseth3
1 Division of Orthopaedic Surgery, Oslo University Hospital, Rikshospitalet, Norway
2 Department of Physical Medicine and Rehabilitation, Drammen Hospital, Vestre Viken Trust, Norway
3 Department of Clinical Medicine, Neuromuscular Diseases and Research Group, University of North Norway, Tromsø, Norway

Article Metrics

CrossRef Citations:
Total Statistics:

Full-Text HTML Views: 795
Abstract HTML Views: 315
PDF Downloads: 198
Total Views/Downloads: 1308
Unique Statistics:

Full-Text HTML Views: 453
Abstract HTML Views: 214
PDF Downloads: 160
Total Views/Downloads: 827

Creative Commons License
© Froholdt et al.; Licensee Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License ( which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the Department of Orthopaedic Surgery, Oslo University Hospital, Rikshospitalet, 0027 Oslo, Norway; Tel: (+47) 90196984; E-mail:



To compare lumbar disc degeneration at 9-year follow-up in patients with chronic low back pain who had instrumented lumbar fusion or no fusion.

Material and methodology:

The main outcomes were disc height and sagittal alignment measured by Distortion Compensated Roentgen Analysis (DCRA). Secondary outcome included the Oswestry Disability Index and VAS back pain.


Forty-eight patients with baseline and 9-year radiographs from L2- S1 were included. Twenty-three had lumbar fusion and 25 had no fusion. Disc height was reduced at all levels independent of fusion. No difference in disc height and sagittal alignment was observed between patients fused and not fused. There were weak correlations, ranging from 0.04 to 0.36, between clinical and radiological parameters.


Lumbar disc degeneration increased at all measured levels independent of fusion and correlated poorly with clinical outcome.

Keywords: : Chronic low back pain, cognitive, disc degeneration, exercise, fusion, long term..