Duration of Disability Following Lumbar Disc Surgery

Surin, Valdemar V.

doi:10.3109/17453677708989733

Cited by 8 publications

(1 citation statement)

References 4 publications

(2 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the contrary, it is clearly a mistake and potentially dangerous obstinately to carry out conservative treatment in all patients with herniated discs, especially because many reports indicate that patients with long-standing preoperative symptoms have fewer chances of obtaining satisfactory results from surgery than those whose symptoms are of short duration [2,7,11,14]. Therefore, two requisites should be borne in mind: to avoid excessively prolonged conservative treatment and to avoid surgery in herniated disc patients who may become asymptomatic through conservative therapy.…”

Section: Introductionmentioning

confidence: 99%

When should conservative treatment for lumbar disc herniation be ceased and surgery considered?

2001

View full text Add to dashboard Cite

Different authors recommend different time spans for conservative treatment before considering surgery in patients suffering from lumbar disc herniation. We analyzed the time of onset of symptoms such as pain, sensory deficit, and motor deficit in a surgically treated group in comparison to outcome after surgery in order to define a time threshold when surgical results deteriorate and operation should therefore be considered. General data, symptoms, signs, and neurological findings of 219 patients were preoperatively recorded. The outcome was evaluated according to the Prolo scale after a mean of 9.9 months. In the statistical workup, we calculated the duration of symptoms, sensory deficits, and motor deficit as continuous variables. Additionally, the population was divided into three groups of duration of symptoms, sensory deficit, or motor deficit for < or = 30 days, 30-60 days, and >60 days. Statistically significant predictors for unfavourable outcome were, for example, a longer duration of preoperative pain and motor and sensory deficit. Patients suffering for more than 60 days from disc herniation were found to have statistically worse outcome than patients suffering for 60 days or less. Findings were similar for the different time groups concerning the duration of sensory deficit but not for duration of motor deficit. The overall outcome seems to be better when patients are operated on for lumbar disc herniations within 2 months after onset of symptoms and sensory deficits. Due to these findings, we recommend conservative treatment up to 2 months and, if conservative management does not succeed, consideration of surgery.

show abstract

Section: Introductionmentioning

confidence: 99%