DOS Kongressen 2014 ·
171
Is the surgical outcome for lumbar disc herniations
related to the duration of symptoms?
Christian Støttrup, Carsten Ernst, Dorte Clemmensen,
Alexander Isenberg-Jørgensen, Randi Holm, Mikkel Østerheden Andersen
Rygkirurgisk sektor, Middelfart Sygehus, Vejle Sygehus
Background:
Lumbar disc herniation (LDH) is associated with great morbidity
and significant socio-economic impact in many parts of the world. Studies have
shown that most LDH can be treated effectively with conservative manage-
ment and the passage of time. However for the group of patients where pain
and disability is unacceptable, surgical intervention provides effective clinical
relief in many cases. Currently there is little consensus in the medical commu-
nity on the timing of surgery for patients suffering from radicular pain due to
LDH. Reports based on the SPORT database indicate that prolonged symptom-
duration correlates with inferior outcome.
Purpose / Aim of Study:
The aim of this study is to evaluate if prolonged
symptom-duration is correlated with less favorable outcome following surgery
for LDH in a Single- Center Study.
Materials and Methods:
832 patients with first-time LDH were included in a
Single-Center Study. Data were prospectively collected in DaneSpine, the Danish
National Spine Register. The patient reported outcome measures (PROM) EQ5D,
SF36, ODI, VAS-leg and -back were correlated with duration of symptoms.
Findings / Results:
832 patients were included in the study, with complete
one-year follow-up on 664 patients (80%) and a reoperation rate of 6%. The
duration of symptoms have a negative correlation on all patient related outcome
measures.
Conclusions:
Delayed surgical intervention results in inferior patient related
outcome. Our results indicate that patients operated within the first 3 months
of leg-pain achieve best outcome.
118.
