A Pilot Study on the Recovery from Paresis After Lumbar Disc Herniation

Dubourg, Geneviève; Rozenberg, Sylvie; Fautrel, Bruno; Valls-Bellec, I.; Bissery, Anne; Lang, Thierry; Faillot, Thierry; Duplan, B.; Briançon, D.; Levy-Weil, Françoise; Morlock, G; Crouzet, J; Gatfosse, Michel; Bonnet, Christine; Houvenagel, É.; Hary, S.; Brocq, Olivier; Poiraudeau, Serge; Beaudreuil, J.; Sauverzac, C. De; Durieux, Stéphanie; Levade, Marc-Henri; Esposito, Philippe; Maitrot, D; Goupille, Philippe; Valat, Jean‐Pierre; Bourgeois, Pierre

doi:10.1097/00007632-200207010-00010

Cited by 69 publications

(43 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Fifteen percent had some improvement but not complete remission, and 10% had no improvement. The recovery rate was similar to the results published earlier [2,6,19,20]. Previous studies evaluating more severe paresis (grade 3 or worse) show similar associations between the severity of paresis and the recovery rate [5,7,21].…”

Section: Discussionsupporting

confidence: 89%

“…We do not know the fate of the paresis if the patient had not been operated. An open prospective multicentre study by Dubourg et al [2] showed no difference in recovery rates after surgical and non-operative treatment. However, in this study there was a selection bias, since surgically treated patients had a higher rate of extruded herniation, higher numbers of paretic muscles and longer duration of sciatica.…”

Section: Discussionmentioning

confidence: 95%

“…It has not been shown that surgery is better than nonsurgical management for treating limb paresis caused by lumbar disc herniation [1][2][3]. However in clinical practice, limb paresis is a frequent additional symptom to pain [4][5][6][7], and for the patients, a major concern remains: ''What are the chances that my muscle strength will recover after surgery?''.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Recovery of muscle strength after microdiscectomy for lumbar disc herniation: a prospective cohort study with 1-year follow-up

et al. 2011

View full text Add to dashboard Cite

Background Surgery has not been proven to be a better treatment option than non-operative management for limb paresis due to lumbar disc herniation. For the patients it will still be a concern, whether they will regain full strength after the operation or not. Methods A prospective cohort study of 91 patients with preoperative paresis due to disc herniation with 1-year follow up was carried out. The primary outcome was muscle strength in affected limb, and the secondary outcome was self-reported symptoms on back and leg pain, disability, health related quality of life, general health and working capability. Results Seventy-five percent of patients had no paresis 1 year after the operation. The severity of the paresis was the only predictor for persistent paresis. Preoperative duration of the paresis did not influence the rate of full recovery. Non-recovery was associated with inferior outcomes and higher risk for reduced working capability. Conclusions The majority of patients with paresis were fully recovered 1 year after microdiscectomy for lumbar disc herniation. If the paresis was severe at baseline, there was a four times higher risk for non-recovery. Patients who did not recover had significantly worse outcomes.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Recovery of muscle strength after microdiscectomy for lumbar disc herniation: a prospective cohort study with 1-year follow-up

et al. 2011

View full text Add to dashboard Cite

show abstract

“…The fact that sound natural progress was seen even in cases where herniation was accompanied by non-progressive neurological deficits regardless of treatment has been reported in numerous studies 4,5,7,10,17,18) in this study as well, it was seen that 14 cases with neurological deficits at the initial diagnosis showed improvement of the neurological deficits at the final follow-up, and in 3 cases only mild residual muscle weakness of Grade 4 was shown and resulted in a good progress. In addition, with the final clinical results showing a 93% (13 out of 14 cases) satisfactory result, it was suggested that, even in cases with neurological deficits at the initial diagnosis, as long as they are not of worsening pattern, conservative treatment should take precedence.…”

Section: ) Agesupporting

confidence: 77%

Conservative Treatment of Lumbar Disc Herniation - A Prospective Study of Disc Herniation Encroaching More than One-third of Spinal Canal -

Shin

Lee

et al. 2011

J Korean Soc Spine Surg

View full text Add to dashboard Cite

“…However, to the best of our knowledge, there are no studies on postural control of patients with LDH in the early postoperative period. Leinonen et al [18] and Bouche et al [4] assessed stability of posture 3 months after the surgery, while Dubourg et al [8] evaluated recovery from paresis due to LDH a month after the surgery, respectively.…”

Section: Introductionmentioning

confidence: 99%

Postural control in patients with lumbar disc herniation in the early postoperative period

2009

View full text Add to dashboard Cite

Chronic spinal disc disease leads to disorders in postural movement coordination. An incorrect asymmetrical movement pattern for the lower limbs loading impairs proprioception and deteriorates postural stability, particularly when the vision is occluded. The standard surgical treatment improves biomechanical conditions in the lumbar spine, reduces pain, yet does it reduce the stability deficit in the upright position? An answer to the latter question would help work out targeted therapy to improve postural stability. We hypothesized that the standard surgical treatment would improve postural stability reflected by decreased sway variability accounting for better use of proprioceptive inputs postoperatively. Thirty-nine patients with lumbar disc herniation participated in the study. Their postural sway was recorded in anterior/posterior and medial/lateral planes with their eyes open or closed (EC) before and after surgery. The variability, range, mean velocity of the recorded time series and the area of the ellipse enclosed by the statokinesiogram were used as measures of postural stability. Preoperatively, EC condition resulted in an increased variability and mean velocity of postural sway, while postoperatively it caused an increase in sway mean velocity and sway area only with no effect on sway variability and range. The comparison of the balance before and after the surgery in the EC condition showed significant decrease in all parameters. In the early postoperative period, the patients recover the ability to control their postural sway in EC within normal limits, however, at the expense of significantly increased frequency of corrective torques. It is probably a transient short-term strategy needed to compensate for the recovery phase when the normal weighting factors for all afferents are being reestablished. We propose that this transient postoperative period may be the best timing of therapeutic intervention targeted at facilitating and reinforcing the acquisition of correct motor patterns.

show abstract

A Pilot Study on the Recovery from Paresis After Lumbar Disc Herniation

Abstract: This pilot study showed no difference between surgical or medical management for recovery or improvement in patients with discogenic paresis. These results need confirmation by a randomized study.

Cited by 69 publications

References 6 publications

Recovery of muscle strength after microdiscectomy for lumbar disc herniation: a prospective cohort study with 1-year follow-up

Recovery of muscle strength after microdiscectomy for lumbar disc herniation: a prospective cohort study with 1-year follow-up

Conservative Treatment of Lumbar Disc Herniation - A Prospective Study of Disc Herniation Encroaching More than One-third of Spinal Canal -

Postural control in patients with lumbar disc herniation in the early postoperative period

Contact Info

Product

Resources

About