Recurrent lumbar disc herniation

Swartz, Karin R.; Trost, Gregory R.

doi:10.3171/foc.2003.15.3.10

Cited by 177 publications

(158 citation statements)

References 22 publications

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“…Fritsch 19 found a significant influence of the patient's sex on the long-term follow-up, with 18% of male patients presenting a satisfactory long-term result in contrast to 32% of females. Other authors have argued against this result 26,27 . A negative influence of age on the outcome has been discussed, with inconclusive data 27 .…”

Section: Discussionmentioning

confidence: 66%

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Is preoperative occupation related to long-term pain in patients operated for lumbar disc herniation?

Almeida

Poletto

Milano

et al. 2007

Arq. Neuro-Psiquiatr.

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-Lumbar disc herniation (LDH) is a common cause of back and sciatic pain. When clinical treatment fails, surgery may be indicated in selected patients. Although surgery is effective in most cases, some of these patients may have a poor outcome. Different factors may influence these results and poor adaptation at work is one well-known cause of treatment failure. This study examines 350 patients on longterm follow-up after surgery for first-time LDH. The relationship was analyzed between occupation before surgery and outcome (maintenance of lumbar and leg pain, satisfaction with the surgical treatment and return to work). The preoperative occupation (employed in public or private services, autonomous, unemployed, housewife, retired or student) and the exertion at work were analyzed as prognostic factors for different clinical outcomes. Although unemployed people had higher numerical analog scale for lumbar pain and retired patients had a higher leg pain, this difference was not statistically significant. Retired people were significantly less satisfied with the surgical result. Higher exertion at work showed a statistically insignificant higher level of pain and lower degree of satisfaction. The authors conclude that preoperative occupation was not a statistically significant factor in this series of patients.KEY WORDS: lumbar disc herniation, occupation, failed back syndrome, outcome, discectomy.Cirurgia de hérnia de disco lombar: existe relação entre a profissão e a persistência de dor?RESUMO -A hérnia de disco lombar (HDL) é uma causa comum de dor lombar e ciática. Quando o tratamento clínico não oferece melhora dos sintomas, a cirurgia pode ser proposta em casos selecionados. Apesar de ser efetiva, uma pequena, porém significativa parcela dos pacientes operados podem não melhorar. Diversos fatores podem influenciar tais resultados. A insatisfação no ambiente de trabalho é relacionada com um maior índice de maus resultados. Neste estudo, 350 pacientes no pós-operatório tardio da primeira cirurgia de HDL foram estudados, analisando a possível relação entre tipo de profissão antes da cirurgia e evolução clínica (persistência de dor lombar e em membro inferior, satisfação com a cirurgia e retorno ao trabalho). Os pacientes foram classificados quanto à profissão em empregados públicos, empregados em órgãos privados, autônomos, desempregados, donas de casa, aposentados e estudantes. Também o grau de esforço no ambiente de trabalho foi analisado como fator prognóstico. Os desempregados relataram índices de dor lombar maiores e os aposentados tiveram maiores índices de dor irradiada, apesar de que estatisticamente os valores não foram significativos. Os aposentados ficaram significativamente menos satisfeitos com o tratamento no longo prazo. Um maior esforço no ambiente de trabalho não se correlacionou estatisticamente com o grau de dor e satisfação. Concluimos que o tipo de profissão não foi fator estatisticamente significativo na evolução destes pacientes. Os aposentados tiveram menor grau de satisfação co...

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Section: Discussionmentioning

confidence: 66%

“…Significant associations have been shown between low-back pain and perceived inadequacy of income, dissatisfaction with work and poorer social class 35 . Poorer outcomes are seen in patients' filing of workers' compensation claims 26 .…”

Section: Discussionmentioning

confidence: 99%

Is preoperative occupation related to long-term pain in patients operated for lumbar disc herniation?

Almeida

Poletto

Milano

et al. 2007

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

show abstract

“…15 A recurrence rate of 5% to 15% for LDH has been reported. [1][2][3][4][5] Differentiation of recurrent disc herniation from scar formation will allow for improved treatment choices and selection of patients who may benefit from a second surgery. Gadoliniumenhanced MRI is thought to be the best modality to differentiate between these two diagnoses.…”

Section: Discussionmentioning

confidence: 99%

“…Recurrent lumbar disc herniation (rLDH) is defined as disc herniation at the same level, regardless of ipsilateral or contralateral herniation, in a patient who has experienced a pain-free interval of at least 6 months after surgery. 1,2 The true incidence of same-level rLDH after lumbar discectomy is unclear.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5] There have been many studies designed to determine the recurrence of LDH, and various risk factors suggested including disc degeneration, trauma, age, smoking, gender, and obesity. 1,3,6 Radiologically identifiable factors, such as disc degeneration, disc height, and sagittal range of motion have been shown to be related to spinal instability and consequently to rLDH.…”

Section: Introductionmentioning

confidence: 99%

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