Omidi-Kashani Farzad, Hasankhani Ebrahim Ghayem, Moghadam Mohammad Hallaj, Esfandiari Mohammad Sadegh
Farzad Omidi-Kashani MD, Ebrahim Ghayem Hasankhani MD, Mohammad Hallaj Moghadam MD, Mohammad Sadegh Esfandiari MD, Orthopedic Research Center Department of Orthopedic Surgery Imam Reza Hospital, Faculty of Medicine Mashhad University of Medical Science, Mashhad, Iran.
Arch Bone Jt Surg. 2013 Dec;1(2):78-81. Epub 2013 Dec 15.
Literature recommends that refractory cases with lumbar disc herniation and appropriate indications are better to be treated surgically, but do all the patients throughout the world consent to the surgery with a same disability and pain threshold? We aim to elucidate the prevalence and severity of disabilities and pain in Iranian patients with lumbar disc herniation who have consented to the surgery.
In this case series study, we clinically evaluated 194 (81 female and 113 male) admitted patients with primary, simple, and stable L4-L5 or L5-S1 lumbar disc herniation who were undergoing surgical discectomy. The mean age of the patients was 38.3±11.2 (range: 18-76 years old). Disabilities were evaluated by the items of the Oswestry Disability Index (ODI) questionnaire and severity of pain by the Visual Analogue Scale (VAS). Chi-square test was used to compare the qualitative variables.
Severe disability (39.2%) and crippled (29.9%) were the two most common types of disabilities. Mean ODI score was 56.7±21.1 (range: 16-92). Total mean VAS in all patients was 6.1±1.9 (range: 0-10). Sex and level of disc herniation had no statistical effect on preoperative ODI and VAS. The scale of six was the most frequent scale of preoperative VAS in our patients.
Iranian patients with lumbar disc herniation who consented to surgery have relatively severe pain or disability. These severities in pain or disabilities have no correlation with sex or level of disc herniation and are not equal with developed countries.
文献表明，腰椎间盘突出症的难治性病例且有合适指征时，手术治疗效果更佳，但全世界所有患者对于手术的接受程度是否都相同，其残疾和疼痛阈值是否都一样？我们旨在阐明同意接受手术治疗的伊朗腰椎间盘突出症患者的残疾和疼痛的患病率及严重程度。
在本病例系列研究中，我们对194例（81例女性和113例男性）因原发性、单纯性和稳定性L4-L5或L5-S1腰椎间盘突出症而接受手术椎间盘切除术的住院患者进行了临床评估。患者的平均年龄为38.3±11.2岁（范围：18-76岁）。通过奥斯威斯利残疾指数（ODI）问卷项目评估残疾情况，通过视觉模拟量表（VAS）评估疼痛严重程度。采用卡方检验比较定性变量。
严重残疾（39.2%）和残疾（29.9%）是两种最常见的残疾类型。平均ODI评分为56.7±21.1（范围：16-92）。所有患者的总平均VAS为6.1±1.9（范围：0-10）。性别和椎间盘突出水平对术前ODI和VAS无统计学影响。在我们的患者中，6分是术前VAS最常见的评分。
同意接受手术治疗的伊朗腰椎间盘突出症患者有相对严重的疼痛或残疾。这些疼痛或残疾的严重程度与性别或椎间盘突出水平无关，且与发达国家不同。
