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).
The short-term follow-up in this study precluded conclusive determination of whether observed improvements may be sustained for longer periods.
“Information from this study and previous studies is vital to treating surgeons so they can provide adequate expectations to their patients undergoing this procedure.”
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