Back pain improves significantly following discectomy for lumbar disc herniation

Publication date: Available online 14 February 2018
Source:The Spine Journal
Author(s): R. Kirk Owens, Leah Y. Carreon, Erica F. Bisson, Mohamad Bydon, Eric A. Potts, Steven D. Glassman
Background ContextAlthough lumbar disc herniation (LDH) classically presents with lower extremity radiculopathy, there are patients who have substantial associated back painPurposeTo determine if patients with lumbar disc herniation (LDH) with substantial back pain improve with decompression alone.Study DesignLongitudinal observational cohortPatient samplePatients enrolled in the Quality and Outcomes Database (QOD) with LDH and a baseline back pain score ≥ 5 of 10 who underwent 1 or 2-level lumbar discectomy onlyOutcome measuresBack and leg pain scores (0-10), Oswestry Disability Index (ODI), and EuroQoL 5D (EQ-5D).Methods. Standard demographic and surgical variables were collected, as well as patient reported outcomes at baseline and at 3 and 12 months postoperatively.ResultsThe mean age of the cohort was 49.8 years and 1195 (52.8%) were male. Mean BMI was 30.1 kg/m². About half of the patients (1103, 48.8%) underwent single level discectomy and the other half (1159, 51.2%) had 2-level discectomy. Average blood loss was 44cc. Most of the patients (2217, 98%) were discharged home with routine postoperative care. The average length of stay was 0.53 days. At 3 months and 12 months postoperatively, there were statistically significant (p<0.000) improvements in back pain (7.7 to 2.9 to 3.2), leg pain (7.5 to 2.3 to 2.5) and ODI (26.2 to 11.6 to 11.2). Patients with a single-level discectomy, compared to patients with a two-level discectomy, had similar improvements in 3- and 12 month back pain, leg pain and ODI scores.ConclusionPatients with LDH who have substantial back pain can be counseled to expect improvement in their back pain scores 12 months after a discectomy.



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