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Patients with no preoperative back pain have the best outcome after lumbar disc herniation surgery

Sigmundsson, Freyr Gauti LU ; Joelson, Anders and Strömqvist, Fredrik LU (2022) In European Spine Journal 31(2). p.408-413
Abstract

Purpose: Most patients with lumbar disc herniations requiring surgery have concomitant back pain. The purpose of the current study was to evaluate the outcome of surgery for lumbar disc herniations in patients with no preoperative back pain (NBP) compared to those reporting low back pain (LBP). Methods: 15,418 patients surgically treated due to LDH with primary discectomy from 1998 until 2020 were included in the study. Self-reported low back pain assessed with a numerical rating scale (NRS) was used to dichotomize the patients in two groups, patients without preoperative back pain (NBP, NRS = 0, n = 1333, 9%) and patients with preoperative low back pain (LBP, NRS > 0, n = 14,085, 91%). Patient reported outcome measures (PROMs)... (More)

Purpose: Most patients with lumbar disc herniations requiring surgery have concomitant back pain. The purpose of the current study was to evaluate the outcome of surgery for lumbar disc herniations in patients with no preoperative back pain (NBP) compared to those reporting low back pain (LBP). Methods: 15,418 patients surgically treated due to LDH with primary discectomy from 1998 until 2020 were included in the study. Self-reported low back pain assessed with a numerical rating scale (NRS) was used to dichotomize the patients in two groups, patients without preoperative back pain (NBP, NRS = 0, n = 1333, 9%) and patients with preoperative low back pain (LBP, NRS > 0, n = 14,085, 91%). Patient reported outcome measures (PROMs) collected preoperatively and one-year postoperatively were used to evaluate differences in outcomes between the groups. Results: At the one-year follow-up, 89% of the patients in the NBP group were completely pain free or much better compared with 76% in the LBP group. Significant improvement regarding leg pain was seen in all measured PROMs in both groups oneyear after surgery. In the NBP group, 13% reported clinically significant back pain (NRS difference greater than Minimally Clinical Important Difference (MICD)) at the one-year follow-up. Conclusions: Patients without preoperative back pain are good candidates for LDH surgery. 13% of patients without preoperative back pain develop clinically significant back pain one-year after surgery.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Back pain, Discectomy, Leg pain, Lumbar disc herniation, Outcome
in
European Spine Journal
volume
31
issue
2
pages
408 - 413
publisher
Springer
external identifiers
  • pmid:34704128
  • scopus:85118144693
ISSN
0940-6719
DOI
10.1007/s00586-021-07033-6
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2021, The Author(s).
id
51f07813-5bba-4cd0-9ba5-35dc295c5389
date added to LUP
2021-11-24 10:56:19
date last changed
2025-03-24 01:01:32
@article{51f07813-5bba-4cd0-9ba5-35dc295c5389,
  abstract     = {{<p>Purpose: Most patients with lumbar disc herniations requiring surgery have concomitant back pain. The purpose of the current study was to evaluate the outcome of surgery for lumbar disc herniations in patients with no preoperative back pain (NBP) compared to those reporting low back pain (LBP). Methods: 15,418 patients surgically treated due to LDH with primary discectomy from 1998 until 2020 were included in the study. Self-reported low back pain assessed with a numerical rating scale (NRS) was used to dichotomize the patients in two groups, patients without preoperative back pain (NBP, NRS = 0, n = 1333, 9%) and patients with preoperative low back pain (LBP, NRS &gt; 0, n = 14,085, 91%). Patient reported outcome measures (PROMs) collected preoperatively and one-year postoperatively were used to evaluate differences in outcomes between the groups. Results: At the one-year follow-up, 89% of the patients in the NBP group were completely pain free or much better compared with 76% in the LBP group. Significant improvement regarding leg pain was seen in all measured PROMs in both groups oneyear after surgery. In the NBP group, 13% reported clinically significant back pain (NRS difference greater than Minimally Clinical Important Difference (MICD)) at the one-year follow-up. Conclusions: Patients without preoperative back pain are good candidates for LDH surgery. 13% of patients without preoperative back pain develop clinically significant back pain one-year after surgery.</p>}},
  author       = {{Sigmundsson, Freyr Gauti and Joelson, Anders and Strömqvist, Fredrik}},
  issn         = {{0940-6719}},
  keywords     = {{Back pain; Discectomy; Leg pain; Lumbar disc herniation; Outcome}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{408--413}},
  publisher    = {{Springer}},
  series       = {{European Spine Journal}},
  title        = {{Patients with no preoperative back pain have the best outcome after lumbar disc herniation surgery}},
  url          = {{http://dx.doi.org/10.1007/s00586-021-07033-6}},
  doi          = {{10.1007/s00586-021-07033-6}},
  volume       = {{31}},
  year         = {{2022}},
}