Patients with a lumbar disc herniation (LDH) and associated back pain may experience improvements in back pain, leg pain, and disability 12 months after single- or 2-level lumbar discectomy, according to a longitudinal observational cohort study published in Spine Journal.

Using data from the Quality and Outcomes Database, investigators assessed 2262 adult patients with LDH with baseline scores for back pain ≥5 on a 10-point rating scale. Patients had a single- or 2-level discectomy (n=1103, n=1159, respectively). Back and leg pain (assessed on a 0 to 10 scale), disability (using the Oswestry Disability Index [ODI]), and health-related quality of life (with the EuroQoL 5D) were evaluated at baseline as well as 3 and 12 months after treatment.

The majority of patients (98%) were discharged with routine care after treatment. On average, the length of hospital stay was 0.53 days. Improvements from baseline to 3 and 12 months after surgery were observed for back pain (pain scores: 7.7, 2.9, and 3.2, respectively), leg pain (pain scores: 7.5, 2.3, and 2.5), and disability (score: 26.2, 11.6, and 11.2, respectively; P <.000 for all). Despite these differences, improvements in back pain, leg pain, and ODI scores were comparable at 3- and 12-month follow-up in patients who had received single- vs 2-level discectomy. Patients in whom leg pain was predominant showed the greatest improvements in disability after treatment compared with baseline (ODI score difference, −31.64).

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The short-term follow-up in this study precluded conclusive determination of whether observed improvements may be sustained for longer periods.

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Owens RK 2nd, Carreon LY, Bisson EF, et al. Back pain improves significantly following discectomy for lumbar disc herniation [published online February 14, 2018]. Spine J. doi:10.1016/j.spinee.2018.02.014