Impairment of perineal care functions after long fusions of the lumbar spine

The purpose of this study was to investigate the incidence of perineal care impairment after extended thoracolumbar and thoracolumbosacral spinal fusions. Fourteen adult patients with fusions from the thoracic spine to L5 or the sacrum completed a questionnaire regarding their ability to do perineal care. The mean number of vertebral levels fused was 9.5 (range, 6-16 levels) with five patients having spinal fusion to L5 and nine having fusion to the sacrum. Thirty-six percent (five of 14 patients) reported difficulty doing perineal care after fusion. Maintenance of L5-S1 segmental motion did not seem to reduce occurrence of perineal care problems. We think that extended thoracolumbar fusion and thoracolumbosacral fusion can produce postoperative difficulty in doing perineal care. Level of Evidence: Therapeutic study, Level IV (case series-no, or historical control group).