Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article


Master of Science


Health and Rehabilitation Sciences


Rushton, Alison


This thesis aimed to investigate the outcomes that are important to measure for patients following LSFS. First, a systematic review identified outcomes that have been measured for patients from existing LSFS literature. Findings from 50 included studies found 35 outcomes have been measured. Second, a secondary analysis of qualitative study explored patients' perceptions identifying 25 outcomes perceived as important to measure. Synthesis of findings across studies showed variability of outcomes and different perspectives reflecting that the outcomes measured in research are sometimes the same, but they can also vary from what patients perceive as important. These outcomes were related to 3 ICF components of body functions, activities and participation and environmental factors, with the activities and participation component highly representative of outcomes important to measure. It was also noted that the ICF did not encompass some outcomes reported. Results were inconclusive in recommending important outcomes following LSFS; therefore, further research conducting a primary qualitative study is needed.

Summary for Lay Audience

Research has used various outcomes to investigate low back pain. However, due to the diversity of the lumbar spinal fusion population, such as differences in surgical fusion levels, and type of surgical procedure, it is not sure if the outcomes used to assess LBP reflect the outcomes important for patients following LSFS. A systematic review was carried out investigating the outcomes that have been measured as reported in existing LSFS literature. There were 50 articles included, and 35 outcomes were identified. Findings showed that pain, walking, carrying out daily routine, and disability are outcomes frequently reported by the included quantitative and qualitative studies. A secondary analysis of qualitative study was also done, which explored patients’ perception of important outcomes to measure following LSFS. Findings showed 25 outcomes were identified with walking, pain relief, and the ability to perform functional activities without pain being the outcomes frequently reported. The results from the two studies were merged, and the synthesis showed a variation of outcomes important to measure for patients. Synthesis showed that the outcomes used in research are sometimes the same and can be very different from what patients think is important to measure. This variation was also shown in the different ICF components of body functions, activities and participation, and environmental factors as outcomes reflected different patterns. This means that what we are doing in literature at the moment in using outcomes may not optimal as there were differences in patients’ perspectives. It was also noted that the ICF did not reflect some outcomes reported in research and by patients. Therefore, future work is needed as the results were inconclusive and specific outcomes could not be recommended as important.