Norton Leatherman Spine Center, 210 East Gray St, Suite 900, Louisville, KY 40202, USA.
Norton Leatherman Spine Center, 210 East Gray St, Suite 900, Louisville, KY 40202, USA.
Spine J. 2018 Sep;18(9):1632-1636. doi: 10.1016/j.spinee.2018.02.014. Epub 2018 Feb 14.
Although lumbar disc herniation (LDH) classically presents with lower extremity radiculopathy, there are patients who have substantial associated back pain.
The present study aims to determine if patients with LDH with substantial back pain improve with decompression alone.
This is a longitudinal observational cohort study.
Patients enrolled in the Quality and Outcomes Database with LDH and a baseline back pain score of ≥5 of 10 who underwent single- or two-level lumbar discectomy only.
Back and leg pain scores (0-10), Oswestry Disability Index (ODI), and EuroQoL 5D were measured.
Standard demographic and surgical variables were collected, as well as patient-reported outcomes at baseline and at 3 and 12 months postoperatively.
The mean age of the cohort was 49.8 years and 1,195 (52.8%) were male. Mean body mass index was 30.1 kg/m. About half of the patients (1,103, 48.8%) underwent single-level discectomy and the other half (1,159, 51.2%) had two-level discectomy. Average blood loss was 44 cc. Most of the patients (2,217, 98%) were discharged home with routine postoperative care. The average length of stay was 0.53 days. At 3 and 12 months postoperatively, there were statistically significant (p<.000) improvements in back pain (from 7.7 to 2.9 to 3.2), leg pain (from 7.5 to 2.3 to 2.5), and ODI (from 26.2 to 11.6 to 11.2). Patients with a single-level discectomy, compared with patients with a two-level discectomy, had similar improvements in 3- and 12-month back pain, leg pain, and ODI scores.
Patients with LDH who have substantial back pain can be counseled to expect improvement in their back pain scores 12 months after a discectomy.
腰椎间盘突出症（LDH）通常表现为下肢神经根病变，但也有一些患者存在明显的腰痛。
本研究旨在确定是否存在腰痛伴严重腰痛的患者，单纯减压治疗是否有效。
这是一项纵向观察性队列研究。
纳入 Quality and Outcomes Database 中基线腰痛评分为≥10 分（满分 10 分）且仅行单节段或双节段腰椎间盘切除术的 LDH 患者。
腰痛和腿痛评分（0-10 分）、Oswestry 残疾指数（ODI）和 EuroQoL 5D。
收集标准的人口统计学和手术变量，以及患者在基线、术后 3 个月和 12 个月的患者报告结局。
队列的平均年龄为 49.8 岁，1195 例（52.8%）为男性。平均 BMI 为 30.1kg/m。约一半的患者（1103 例，48.8%）行单节段椎间盘切除术，另一半（1159 例，51.2%）行双节段椎间盘切除术。平均失血量为 44cc。大多数患者（2217 例，98%）接受常规术后护理后出院回家。平均住院时间为 0.53 天。术后 3 个月和 12 个月时，腰痛（从 7.7 分降至 2.9 分再降至 3.2 分）、腿痛（从 7.5 分降至 2.3 分再降至 2.5 分）和 ODI（从 26.2 分降至 11.6 分再降至 11.2 分）均有统计学意义（p<.000）的改善。与双节段椎间盘切除术相比，行单节段椎间盘切除术的患者在术后 3 个月和 12 个月时腰痛、腿痛和 ODI 评分的改善情况相似。
腰痛伴严重腰痛的 LDH 患者在椎间盘切除术后 12 个月可预期腰痛评分得到改善。
