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Predictive outcome factors in the young patient treated with lumbar disc herniation surgery

Strömqvist, Fredrik LU ; Strömqvist, Björn LU ; Jönsson, Bo LU ; Gerdhem, Paul LU and Karlsson, Magnus K. LU (2016) In Journal of Neurosurgery: Spine 25(4). p.448-455
Abstract

OBJECTIVE: The aim of this study was to evaluate predictive factors for outcome after lumbar disc herniation surgery in young patients. METHODS: In the national Swedish spine register, the authors identified 180 patients age 20 years or younger, in whom preoperative and 1-year postoperative data were available. The cohort was treated with primary open surgery due to lumbar disc herniation between 2000 and 2010. Before and 1 year after surgery, the patients graded their back and leg pain on a visual analog scale, quality of life by the 36-Item Short-Form Health Survey and EuroQol-5 Dimensions, and disability by the Oswestry Disability Index. Subjective satisfaction rate was registered on a Likert scale (satisfied, undecided, or... (More)

OBJECTIVE: The aim of this study was to evaluate predictive factors for outcome after lumbar disc herniation surgery in young patients. METHODS: In the national Swedish spine register, the authors identified 180 patients age 20 years or younger, in whom preoperative and 1-year postoperative data were available. The cohort was treated with primary open surgery due to lumbar disc herniation between 2000 and 2010. Before and 1 year after surgery, the patients graded their back and leg pain on a visual analog scale, quality of life by the 36-Item Short-Form Health Survey and EuroQol-5 Dimensions, and disability by the Oswestry Disability Index. Subjective satisfaction rate was registered on a Likert scale (satisfied, undecided, or dissatisfied). The authors evaluated if age, sex, preoperative level of leg and back pain, duration of leg pain, pain distribution, quality of life, mental status, and/or disability were associated with the outcome. The primary end point variable was the grade of patient satisfaction. RESULTS: Lumbar disc herniation surgery in young patients normalizes quality of life according to the 36-Item Short- Form Health Survey, and only 4.5% of the patients were unsatisfied with the surgical outcome. Predictive factors for inferior postoperative patient-reported outcome measures (PROM) scores were severe preoperative leg or back pain, low preoperative mental health, and pronounced preoperative disability, but only low preoperative mental health was associated with inferiority in the subjective grade of satisfaction. No associations were found between preoperative duration of leg pain, distribution of pain, or health-related quality of life and the postoperative PROM scores or the subjective grade of satisfaction. CONCLUSIONS: Lumbar disc herniation surgery in young patients generally yields a satisfactory outcome. Severe preoperative pain, low mental health, and severe disability increase the risk of reaching low postoperative PROM scores, but are only of relevance clinically (low subjective satisfaction) for patients with low preoperative mental health.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Lumbar disc herniation, Outcome, Patient-reported outcome measures, Prediction, PROM, Sex, Surgery
in
Journal of Neurosurgery: Spine
volume
25
issue
4
pages
8 pages
publisher
American Association of Neurological Surgeons
external identifiers
  • scopus:84990855428
  • wos:000383938700005
ISSN
1547-5654
DOI
10.3171/2016.2.SPINE16136
language
English
LU publication?
yes
id
be9de809-0584-4171-aaf7-e0fa847b810b
date added to LUP
2016-11-16 11:48:49
date last changed
2017-06-11 05:10:22
@article{be9de809-0584-4171-aaf7-e0fa847b810b,
  abstract     = {<p>OBJECTIVE: The aim of this study was to evaluate predictive factors for outcome after lumbar disc herniation surgery in young patients. METHODS: In the national Swedish spine register, the authors identified 180 patients age 20 years or younger, in whom preoperative and 1-year postoperative data were available. The cohort was treated with primary open surgery due to lumbar disc herniation between 2000 and 2010. Before and 1 year after surgery, the patients graded their back and leg pain on a visual analog scale, quality of life by the 36-Item Short-Form Health Survey and EuroQol-5 Dimensions, and disability by the Oswestry Disability Index. Subjective satisfaction rate was registered on a Likert scale (satisfied, undecided, or dissatisfied). The authors evaluated if age, sex, preoperative level of leg and back pain, duration of leg pain, pain distribution, quality of life, mental status, and/or disability were associated with the outcome. The primary end point variable was the grade of patient satisfaction. RESULTS: Lumbar disc herniation surgery in young patients normalizes quality of life according to the 36-Item Short- Form Health Survey, and only 4.5% of the patients were unsatisfied with the surgical outcome. Predictive factors for inferior postoperative patient-reported outcome measures (PROM) scores were severe preoperative leg or back pain, low preoperative mental health, and pronounced preoperative disability, but only low preoperative mental health was associated with inferiority in the subjective grade of satisfaction. No associations were found between preoperative duration of leg pain, distribution of pain, or health-related quality of life and the postoperative PROM scores or the subjective grade of satisfaction. CONCLUSIONS: Lumbar disc herniation surgery in young patients generally yields a satisfactory outcome. Severe preoperative pain, low mental health, and severe disability increase the risk of reaching low postoperative PROM scores, but are only of relevance clinically (low subjective satisfaction) for patients with low preoperative mental health.</p>},
  author       = {Strömqvist, Fredrik and Strömqvist, Björn and Jönsson, Bo and Gerdhem, Paul and Karlsson, Magnus K.},
  issn         = {1547-5654},
  keyword      = {Lumbar disc herniation,Outcome,Patient-reported outcome measures,Prediction,PROM,Sex,Surgery},
  language     = {eng},
  month        = {10},
  number       = {4},
  pages        = {448--455},
  publisher    = {American Association of Neurological Surgeons},
  series       = {Journal of Neurosurgery: Spine},
  title        = {Predictive outcome factors in the young patient treated with lumbar disc herniation surgery},
  url          = {http://dx.doi.org/10.3171/2016.2.SPINE16136},
  volume       = {25},
  year         = {2016},
}