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Full-Endoscopic Isolation Zone Technique for the Treatment of Lumbar Disc Herniation
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Predicting conservative treatment failure in patients with lumbar disc herniation. Single center, case-control study
Krzysztof Ostafiński1, Wojciech Świątnicki2, Jarosław Szymański3
1Neurological Rehabilitation Unit, Maria Skłodowska-Curie Hospital, District of Łódź-North, Zgierz, Poland.
Objectives:
The aim of this study was to identify independent predictors of conservative treatment failure in patients presenting due to lumbar disc herniation-associated low back pain and sciatica.
Patients And Methods:
This is a single institution, case-control study including 240 patients that were selected for microsurgical or conservative treatment due to lumbar disc herniation in a 2,5-year period. Bivariate and multivariate analyses were performed in order to identify independent predictors among demographic, clinical and radiographic factors.
Results:
Statistically significant differences were observed between conservatively and surgically managed groups in bivariate analysis. Logistic regression models further revealed that leg paresthesia (p = 0,003; OR = 5,136) and percentage of spinal canal stenosis ratio (p < 0,001; OR = 1,055) had the strongest, independent correlation with conservative treatment failure in our cohort. Back-to-leg ratio did not reach statistical significance although it proved a strong correlation in bivariate analysis (p < 0,001, Cramér's V = 0,53).
Conclusion:
Increasing % canal compromise ratio (cut-off value 23%) and co-occurrence of leg paresthesia were the most important risk factors for surgery in our series of patients.
