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Corresponding author: Seung Hwan Yoon Department of Neurosurgery, Inha University School of Medicine, 27, Inhang-ro, Jung-gu, Incheon 22332, Republic of Korea Tel: +82-32-890-2370 Fax: +82-32-890-2374 E-mail: nsyoon@gmail.com Objective: The purpose of this study was to compare the range of motion (ROM) after spinal fusion according to the levels of lumbar spinal fusion (L4/5 and/or L5/S1). Methods: One hundred fifty-six patients were included in this study after undergoing thoracolumbar or lumbar fusion from April 2010 to December 2016. All patients had a numerical rating scale less than 4. We categorized the patients according to the fusion level for statistical purposes: 86 patients in group I with L4/5 or L3/4/5 fusion, 24 in group II with only L5/S1 fusion, 34 in group III with L4/5/S1 or L3/4/5/S1 fusion, and 12 in group IV with T10-S1 fusion for lesions. The ROM was evaluated by physicians of the rehabilitation medicine department using a blinded method, and the result was compared between each group. The student t-test was used in the statistical analysis. Results: The ROM of lumbar flexion was not different between each group, except for groups I and IV (p=0.038). The ROM of lumbar extension was statistically affected by fusion at the L4/5 or L5/S1 level. The ROM of lumbar lateral flexion had a tendency of being affected by fusion at the L4/5 or L5/S1 level. The ROM of lumbar lateral rotation was not affected by fusion at the L4/5 or L5/S1 level. Conclusion: The results suggest that the lower lumbar segments (L4/5 and especially L5/S1) contribute to spinal ROM (extension and lateral flexion), but these segments alone do not play significant roles in spinal flexion movements.

Range of Motion According to the Fusion Level after Lumbar Spine Fusion: A Retrospective Study