Sørensen Simon Thorbjørn, Bech-Azeddine Rachid, Fruensgaard Søren, Andersen Mikkel Østerheden, Carreon Leah
1Center for Spine Surgery & Research, Middelfart Hospital, Middelfart.
2Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup; and.
J Neurosurg Spine. 2020 Jul 10;33(5):623-626. doi: 10.3171/2020.4.SPINE191382.
Patients with lumbar disc herniation (LDH) typically present with lower-extremity radiculopathy. However, there are patients who have concomitant substantial back pain (BP) and are considered candidates for fusion. The purpose of this study was to determine if patients with LDH and substantial BP improve with discectomy alone.
The DaneSpine database was used to identify 2399 patients with LDH and baseline BP visual analog scale (VAS) scores ≥ 50 who underwent a lumbar discectomy at one of 3 facilities between June 2010 and December 2017. Standard demographic and surgical variables and patient-reported outcomes, including BP and leg pain (LP) VAS scores (0-100), Oswestry Disability Index (ODI), and European Quality of Life-5 Dimensions Questionnaire (EQ-5D) at baseline and 12 months postoperatively, were collected.
A total of 1654 patients (69%) had 12-month data available, with a mean age of 48.7 years; 816 (49%) were male and the mean BMI was 27 kg/m2. At 12 months postoperatively, there were statistically significant improvements (p < 0.0001) in BP (72.6 to 36.9), LP (74.8 to 32.6), ODI (50.9 to 25.1), and EQ-5D (0.25 to 0.65) scores.
Patients with LDH and LP and concomitant substantial BP can be counseled to expect improvement in their BP 12 months after surgery after a discectomy alone, as well as improvement in their LP.
腰椎间盘突出症（LDH）患者通常表现为下肢神经根病。然而，有一部分患者同时伴有严重的背痛（BP），被认为是融合手术的候选者。本研究的目的是确定单纯行椎间盘切除术的LDH伴严重BP患者的病情是否会改善。
利用丹麦脊柱数据库，识别出2399例LDH患者，这些患者的基线BP视觉模拟量表（VAS）评分≥50，于2010年6月至2017年12月期间在3家机构之一接受了腰椎间盘切除术。收集了标准的人口统计学和手术变量以及患者报告的结局，包括基线和术后12个月时的BP和腿痛（LP）VAS评分（0 - 100）、Oswestry功能障碍指数（ODI）和欧洲生活质量五维度问卷（EQ - 5D）。
共有1654例患者（69%）有12个月的数据，平均年龄为48.7岁；816例（49%）为男性，平均BMI为27kg/m²。术后12个月时，BP（从72.6降至36.9）、LP（从74.8降至32.6）、ODI（从50.9降至25.1）和EQ - 5D（从0.25升至0.65）评分有统计学显著改善（p < 0.0001）。
对于LDH伴LP且同时伴有严重BP的患者，可以告知他们，单纯行椎间盘切除术后12个月，其BP以及LP有望改善。
