Prognosis in Sciatica: A Clinical Follow-Up of Surgical and Non-Surgical Treatment

Hakelius, Anders

doi:10.3109/ort.1970.41.suppl-129.01

Cited by 173 publications

(71 citation statements)

References 71 publications

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“…Поясничный спинальный стеноз относится к достаточно распростра-ненным заболеваниям (1:1000 населе-ния) [6,7,17,18]. Его инцидентность значительно возросла за последние несколько лет, что во многом связа-но с увеличением средней продолжи-тельности жизни [24].…”

Section: Discussionunclassified

Assessment of the Degree of Spinal Canal Narrowing in Lumbar Spinal Stenosis

Макиров¹,

Осадчий²,

Юз³

2018

Hir. pozvonoč.

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Objective. To analyze the method for assessing a degree of spinal canal narrowing based on anatomical aspects of lumbar spinal stenosis. Material and Methods. Twenty two patients with 41 stenotic segments were involved in the study. Mean age of patients was 51.8 years. Mean number of stenotic segments in one patient was 2.1. Eight radiological criteria were measured in all patients. Measurements were carried out at the level of the middle of intervertebral disc and facet joints. The linear pair correlation was calculated for all criteria. The regression equations were composed based on correlation coefficients. Results. Strong linear correlation between the linear and area variables was found. The analysis of regression equations showed the adequacy of mathematical models and high value of the multiple correlation coefficient. To describe a degree of spinal canal narrowing the authors suggested using a stenosis coefficient as the ratio of the sum of lateral canal areas to the dural sac cross-sectional area.Comparison between average values of this coefficient in the study and the control groups showed statistically significant differences. Conclusion. The new approach to searching for an optimal radiological criteria of spinal canal narrowing is used. Based on the obtained data, the parameter "stenosis coefficient" is introduced, which has high correlation with the numerical grading scales. Results obtained in the small sample are encouraging.

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Section: Discussionunclassified

Assessment of the Degree of Spinal Canal Narrowing in Lumbar Spinal Stenosis

Макиров¹,

Осадчий²,

Юз³

2018

Hir. pozvonoč.

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“…Compensation status is often associated with poor outcomes after therapeutic intervention. 5,36,37 However, these patients also demonstrate decreased surgical success. 37 Specifically, patients receiving workers' compensation who had lumbar discectomy and lumbar fusion had worse surgical outcomes than patients who were not receiving workers' compensation.…”

Section: Discussionmentioning

confidence: 99%

Transforaminal epidural steroid injections prevent the need for surgery in patients with sciatica secondary to lumbar disc herniation: a retrospective case series

McKeon

2013

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Background:The median orthopedic surgery wait time in Canada is 33.7 weeks, thus alternative treatments for pathologies such as lumbar disc herniations (LDH) are needed. We sought to determine whether transforaminal epidural steroid injections (TFESIs) alleviate or merely delay the need for surgery. Methods:We retrospectively reviewed the charts of patients with LDH who received TFESIs between September 2006 and July 2008. Patient demographics, level and side of pathology, workers' compensation status, levels injected, treatment outcome and time from referral to treatment were evaluated. The primary outcome measure was the need for versus the avoidance of surgery. Results:We included 91 patients in our analysis. Time from family physician referral to injection was 123 (standard deviation [SD] 88) days; no significant differences in wait times were found between TFESI patients and those requiring surgery. In all, 51 patients (22 women, 29 men) with a mean age of 45.8 (SD 10.2) years avoided surgery following TFESI, whereas 40 patients (16 women, 24 mean) with a mean age of 43.1 (SD 12.0) years proceeded to surgery within 189 (SD 125) days postinjection. In all, 15 patients received multiple injections, and of these, 9 did not require surgical intervention. Age, sex and level/side of pathology did not influence the treatment outcome. Workers' compensation status influenced outcome significantly; these patients demonstrated less benefit from TFESI. Conclusion:Transforaminal epidural steroid injections are an important treatment tool, preventing the need for surgery in 56% of patients with LDH.

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“…After the study by Hakelius et al 3) on the natural progress of patients with radiating pain, although many reports about the sound natural progress of herniated disc patients along with surgery and conservative treatment have been www.krspine.org published, there have been significant disagreements regarding the results. This is believed to be attributable to the differences in diagnostic methods which, importantly, caused the study subject groups to be different.…”

Section: Introductionmentioning

confidence: 98%