Details

Autor(en) / Beteiligte

• Hareni, Niyaz
• Strömqvist, Fredrik
• Strömqvist, Björn
• Sigmundsson, Freyr Gauti
• Rosengren, Björn E
• Karlsson, Magnus K

Titel

Back pain is also improved by lumbar disc herniation surgery

Ist Teil von

• Acta orthopaedica, 2021-02, Vol.92 (1), p.4-8

Ort / Verlag

England: Taylor & Francis

Erscheinungsjahr

2021

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Background and purpose - Indication for lumbar disc herniation (LDH) surgery is usually to relieve sciatica. We evaluated whether back pain also decreases after LDH surgery. Patients and methods - In the Swedish register for spinal surgery (SweSpine) we identified 14,097 patients aged 20-64 years, with pre- and postoperative data, who in 2000-2016 had LDH surgery. We calculated 1-year improvement on numeric rating scale (rating 0-10) in back pain (N back ) and leg pain (N leg ) and by negative binomial regression relative risk (RR) for gaining improvement exceeding minimum clinically important difference (MCID). Results - N leg was preoperatively (mean [SD]) 6.7 (2.5) and N back was 4.7 (2.9) (p < 0.001). Surgery reduced N leg by mean 4.5 (95% CI 4.5-4.6) and N back by 2.2 (CI 2.1-2.2). Mean reduction in N leg ) was 67% and in N back 47% (p < 0.001). Among patients with preoperative pain ≥ MCID (that is, patients with significant baseline pain and with a theoretical possibility to improve above MCID), the proportion who reached improvement ≥ MCID was 79% in N leg and 60% in N back . RR for gaining improvement ≥ MCID in smokers compared with non-smokers was for N leg 0.9 (CI 0.8-0.9) and ­N back 0.9 (CI 0.8-0.9), and in patients with preoperative duration of back pain 0-3 months compared with > 24 months for N leg 1.3 (CI 1.2-1.5) and for N back 1.4 (CI 1.2-1.5). Interpretation - LDH surgery improves leg pain more than back pain; nevertheless, 60% of the patients with significant back pain improved ≥ MCID. Smoking and long duration of pain is associated with inferior recovery in both N leg and N back .