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Clinical factors of importance for outcome after lumbar disc herniation surgery: long-term follow-up

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An Erratum to this article was published on 17 July 2010

Abstract

Factors as age, sex, smoking, duration of leg pain, working status, type/level of disc herniation and psychosocial factors have been demonstrated to be of importance for short-term results after lumbar discectomy. There are few studies with long-term follow-up. In this prospective study of lumbar disc herniation patients undergoing surgery, the result was evaluated at 2 and 5–10 (mean 7.3) years after surgery. Predictive factors for satisfaction with treatment and objective outcome were investigated. Out of the included 171 patients undergoing lumbar discectomy, 154 (90%) patients completed the 2-year follow-up and 140 (81%) completed the long-term follow-up. Baseline data and questionnaires about leg- and back pain intensity (VAS), duration of leg pain, disability (Oswestry Disability Index), depression (Zung Depression Scale), sick leave and employment status were obtained preoperatively, at 2-year- and long-term follow-up. Primary outcome included patient satisfaction with treatment (at both time points) and assessment of an independent observer at the 2-year follow-up. Secondary outcomes at 2-year follow-up were improvement of leg and back pain, working capacity and the need for analgesics or sleeping pills. In about 70% of the patients excellent or good overall result was reported at both follow-ups, with subjective outcome measurements. The objective evaluation after 2 years was in agreement with this result. Time on sick leave was found to be a clinically important predictor of the primary outcomes, with a potential of changing the probability of a satisfactory outcome (both objective and subjective) from around 50% (sick leave >3 months) to 80% (sick leave <2 months). Time on sick leave was also an important predictor for several of the secondary outcomes; e.g. working capacity and the need for analgesics.

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References

  1. Ng LC, Sell P (2004) Predictive value of the duration of sciatica for lumbar discectomy. A prospective cohort study. J Bone Joint Surg Br 86(4):546–549

    CAS  PubMed  Google Scholar 

  2. Atlas SJ et al (2005) Long-term outcomes of surgical and nonsurgical management of sciatica secondary to a lumbar disc herniation: 10 year results from the Maine lumbar spine study. Spine 30(8):927–935

    Article  PubMed  Google Scholar 

  3. Asch HL et al (2002) Prospective multiple outcomes study of outpatient lumbar microdiscectomy: should 75 to 80% success rates be the norm? J Neurosurg 96(1 Suppl):34–44

    PubMed  Google Scholar 

  4. Dewing CB et al (2008) The outcomes of lumbar microdiscectomy in a young, active population: correlation by herniation type and level. Spine 33(1):33–38

    Article  PubMed  Google Scholar 

  5. Ronnberg K et al (2007) Patients’ satisfaction with provided care/information and expectations on clinical outcome after lumbar disc herniation surgery. Spine (Phila Pa 1976) 32(2):256–261

    Google Scholar 

  6. Hakkinen A et al (2003) Does the outcome 2 months after lumbar disc surgery predict the outcome 12 months later? Disabil Rehabil 25(17):968–972

    Article  PubMed  Google Scholar 

  7. Loupasis GA et al (1999) Seven- to 20-year outcome of lumbar discectomy. Spine (Phila Pa 1976) 24(22):2313–2317

    CAS  Google Scholar 

  8. Weber H (1983) Lumbar disc herniation. A controlled, prospective study with ten years of observation. Spine (Phila Pa 1976) 8(2):131–140

    CAS  Google Scholar 

  9. Weinstein JN et al (2008) Surgical versus nonoperative treatment for lumbar disc herniation: four-year results for the Spine Patient Outcomes Research Trial (SPORT). Spine 33(25):2789–2800

    Article  PubMed  Google Scholar 

  10. Rothoerl RD et al (1998) Are there differences in the symptoms, signs and outcome after lumbar disc surgery in the elderly compared with younger patients? Br J Neurosurg 12(3):250–253

    Article  CAS  PubMed  Google Scholar 

  11. Peul WC et al (2008) Influence of gender and other prognostic factors on outcome of sciatica. Pain 138(1):180–191

    Article  PubMed  Google Scholar 

  12. Nygaard OP, Kloster R, Solberg T (2000) Duration of leg pain as a predictor of outcome after surgery for lumbar disc herniation: a prospective cohort study with 1-year follow up. J Neurosurg 92(2 Suppl):131–134

    CAS  PubMed  Google Scholar 

  13. Rothoerl RD, Woertgen C, Brawanski A (2002) When should conservative treatment for lumbar disc herniation be ceased and surgery considered? Neurosurg Rev 25(3):162–165

    Article  PubMed  Google Scholar 

  14. Almeida DB et al (2007) Is preoperative occupation related to long-term pain in patients operated for lumbar disc herniation? Arq Neuropsiquiatr 65(3B):758–763

    PubMed  Google Scholar 

  15. Halldin K et al (2009) Three-dimensional radiological classification of lumbar disc herniation in relation to surgical outcome. Int Orthop 33(3):725–730

    Article  CAS  PubMed  Google Scholar 

  16. Carragee EJ et al (2003) Clinical outcomes after lumbar discectomy for sciatica: the effects of fragment type and anular competence. J Bone Joint Surg Am 85-A(1):102–108

    PubMed  Google Scholar 

  17. Kohlboeck G et al (2004) Prognosis of multifactorial outcome in lumbar discectomy: a prospective longitudinal study investigating patients with disc prolapse. Clin J Pain 20(6):455–461

    Article  PubMed  Google Scholar 

  18. Junge A et al (1996) Predictors of bad and good outcome of lumbar spine surgery. A prospective clinical study with 2 years’ follow up. Spine 21(9):1056–1064 (discussion 1064–1065)

    Article  CAS  PubMed  Google Scholar 

  19. Zung WW (1965) A self-rating depression scale. Arch Gen Psychiatry 12:63–70

    CAS  PubMed  Google Scholar 

  20. Fairbank JC, Pynsent PB (2000) The Oswestry Disability Index. Spine 25(22):2940–2952 (discussion 2952)

    Article  CAS  PubMed  Google Scholar 

  21. Fairbank JC et al (1980) The Oswestry low back pain disability questionnaire. Physiotherapy 66(8):271–273

    CAS  PubMed  Google Scholar 

  22. Macnab I (1973) Chapter 14. Pain and disability in degenerative disc disease. Clin Neurosurg 20:193–196

    CAS  PubMed  Google Scholar 

  23. Nygaard OP, Romner B, Trumpy JH (1994) Duration of symptoms as a predictor of outcome after lumbar disc surgery. Acta Neurochir (Wien) 128(1–4):53–56

    Article  CAS  Google Scholar 

  24. Kitze K et al (2008) Preoperative predictors for the return to work of herniated disc patients. Zentralbl Neurochir 69(1):7–13

    Article  CAS  PubMed  Google Scholar 

  25. Hurme M, Alaranta H (1987) Factors predicting the result of surgery for lumbar intervertebral disc herniation. Spine 12(9):933–938

    Article  CAS  PubMed  Google Scholar 

  26. Ronnberg K et al (2008) Peridural scar and its relation to clinical outcome: a randomised study on surgically treated lumbar disc herniation patients. Eur Spine J 17(12):1714–1720

    Article  PubMed  Google Scholar 

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Acknowledgments

The study was supported with grants from Marianne och Marcus Wallenberg’s Foundation, ALF Västra Götaland, Gothenburg Medical association, The Swedish Society of Medicine and the The Neubergh Foundation.

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Authors and Affiliations

  1. Department of Orthopaedics, Sahlgrenska University Hospital, Göteborg University, 413 45, Gothenburg, Sweden

    Katarina Silverplats, B. Lind, K. Halldin & H. Brisby

  2. Department of Orthopaedics, Landspitali University Hospital, Reykjavik, Iceland

    B. Zoëga

  3. Department of Orthopaedics, Trollhättan/Uddevalla University, Uddevalla, Sweden

    M. Gellerstedt

  4. Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden

    L. Rutberg

Authors
  1. Katarina Silverplats
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  2. B. Lind
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  3. B. Zoëga
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  4. K. Halldin
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  5. M. Gellerstedt
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  6. H. Brisby
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  7. L. Rutberg
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Corresponding author

Correspondence to Katarina Silverplats.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s00586-010-1511-x

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Silverplats, K., Lind, B., Zoëga, B. et al. Clinical factors of importance for outcome after lumbar disc herniation surgery: long-term follow-up. Eur Spine J 19, 1459–1467 (2010). https://doi.org/10.1007/s00586-010-1433-7

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  • DOI: https://doi.org/10.1007/s00586-010-1433-7

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