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A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations
Published on: August 7, 2018
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Back pain is also improved by lumbar disc herniation surgery
Niyaz Hareni1,2, Fredrik Strömqvist2, Björn Strömqvist2
1Department of Orthopaedics, Varberg Hospital, Varberg.
Acta Orthopaedica
|September 8, 2020
Summary
Lumbar disc herniation surgery significantly reduces leg pain and also improves back pain in most patients. However, factors like smoking and prolonged pain duration can negatively impact recovery outcomes.
Area of Science:
- Neurosurgery
- Orthopedics
- Pain Management
Background:
- Lumbar disc herniation (LDH) surgery is primarily indicated to alleviate sciatica (leg pain).
- The impact of LDH surgery on associated back pain is less understood.
- Evaluating both leg and back pain reduction is crucial for a comprehensive understanding of surgical outcomes.
Purpose of the Study:
- To assess the effectiveness of LDH surgery in reducing both leg pain and back pain.
- To determine the proportion of patients achieving clinically significant improvement in back pain post-surgery.
- To identify factors influencing recovery from leg and back pain after LDH surgery.
Main Methods:
- Analysis of 14,097 patients undergoing LDH surgery between 2000-2016 from the Swedish register for spinal surgery (SweSpine).
- Calculation of 1-year improvement in leg pain (Nleg) and back pain (Nback) using the numeric rating scale (0-10).
- Negative binomial regression used to determine relative risk (RR) for achieving improvement exceeding the minimum clinically important difference (MCID).
Main Results:
- Preoperative leg pain (mean 6.7) and back pain (mean 4.7) were significantly reduced by surgery (leg pain by 4.5, back pain by 2.2).
- Mean reduction was 67% for leg pain and 47% for back pain.
- Among patients with significant baseline pain, 79% achieved MCID for leg pain, and 60% for back pain.
Conclusions:
- LDH surgery is highly effective in improving leg pain, with significant benefits also observed for back pain.
- Factors such as smoking and longer preoperative pain duration are associated with poorer outcomes for both leg and back pain.
- Despite these factors, a majority of patients with significant preoperative back pain experience clinically meaningful improvement after LDH surgery.
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