25dkou337 10.3205/25dkou337 urn:nbn:de:0183-25dkou3378 Meeting Abstract Hambrecht Hambrecht Jan J

Universitätsklinik Balgrist, Schweiz, Hospital for Special Surgery, New York, USA Universitätsklinik Balgrist, Zürich, Schweiz

author Köhli Köhli Paul P

Universitätsklinik Balgrist, Schweiz, Hospital for Special Surgery, New York, USA

author Chiapparelli Chiapparelli Erika E author Lan Lan Ranqing R

Universitätsklinik Balgrist, Schweiz, Hospital for Special Surgery, New York, USA

author Duculan Duculan Roland R

Universitätsklinik Balgrist, Schweiz, Hospital for Special Surgery, New York, USA

author Shue Shue Jennifer J

Universitätsklinik Balgrist, Schweiz, Hospital for Special Surgery, New York, USA

author Mancuso Mancuso Carol C

Universitätsklinik Balgrist, Schweiz, Hospital for Special Surgery, New York, USA

author Hughes Hughes Alexander A

Universitätsklinik Balgrist, Schweiz, Hospital for Special Surgery, New York, USA

author German Medical Science GMS Publishing House

Düsseldorf

610 20251031 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0634 337 Deutsche Gesellschaft für Orthopädie und Unfallchirurgie Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie Deutsche Gesellschaft für Unfallchirurgie Berufsverband für Orthopädie und Unfallchirurgie Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2025) Abstracts | Wirbelsäule 1 Berlin 20251028 20251031 AB51-3059 TextObjectives and questions: The ODI and postoperative satisfaction are important markers of postoperative success. While ODI improvement is expected to correlate with satisfaction, their exact relationship remains unclear. Additionally, some patients may achieve functional improvement yet report non-satisfaction postoperatively. This study investigates the risk factors for postoperative non-satisfaction despite improvement in the Oswestry Disability Index (ODI) two years after elective lumbar surgery.Material and methods: A secondary analysis was performed on a prospective study of patients undergoing lumbar surgery for degenerative conditions. Patients with a 2-year ODI and satisfaction follow-up were included. Risk factors for non-satisfaction despite ODI improvement were investigated using t-tests, Wilcoxon-tests, and Fisher’s-exact-tests. Significant variables were analyzed with multivariable logistic regression, adjusting for age, sex and BMI.Results: 55 patients (65±10 years, 58% female) were included. Non-satisfied patients showed significantly higher scores in pre- (64 [52–76], p<0.001) and postoperative (36 [20–44], p<0.001) ODI and lower absolute (18 [8–30], p<0.001) and percentage (30 [17–52], p<0.001) improvement rates from pre- to postoperatively. Higher baseline (OR1.03, 95% CI 1.01–1.05, p<0.001) and postoperative (OR1.08, 95%CI 1.06–1.10, p<0.001) ODI scores, and lower absolute (OR0.94, 95% CI 0.92–0.96, p<0.001) and percentage (OR0.95, 95% CI 0.94–0.97, p<0.001) improvement rates, were significant risk factors for experiencing non-satisfaction, despite ODI improvement. Higher fat infiltration (FI) of the multifidus (MF) (OR1.03, 95% CI 1.00–1.06, p=0.042) or the erector spinae (ES) (OR1.06, 95% CI 1.03–1.09, p<0.001) were significantly correlated with postoperative non-satisfaction, after adjusting for covariates.Discussion and conclusion: Higher pre- and postoperative ODI scores and lower ODI improvement were linked to postoperative non-satisfaction. Higher FI in the MF or ES was also a significant risk factor for postoperative non-satisfaction, despite ODI improvement. The findings highlight that postoperative satisfaction is influenced by various factors affected by ODI-measured disability. Additionally, paraspinal muscle health greatly affects postoperative outcomes and should guide preoperative planning and postoperative care. 0 0 0 0