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Back pain is also improved by lumbar disc herniation surgery

Hareni, Niyaz LU ; Strömqvist, Fredrik LU ; Strömqvist, Björn LU ; Sigmundsson, Freyr Gauti LU ; Rosengren, Björn E. LU and Karlsson, Magnus K. LU (2021) In Acta Orthopaedica 92(1). p.4-8
Abstract

Background and purpose — Indication for lumbar disc herniation (LDH) surgery is usually to relieve sciatica. We evaluated whether back pain also decreases after LDH surgery. Patients and methods — In the Swedish register for spinal surgery (SweSpine) we identified 14,097 patients aged 20–64 years, with pre- and postoperative data, who in 2000–2016 had LDH surgery. We calculated 1-year improvement on numeric rating scale (rating 0–10) in back pain (Nback) and leg pain (Nleg) and by negative binomial regression relative risk (RR) for gaining improvement exceeding minimum clinically important difference (MCID). Results — Nleg was preoperatively (mean [SD]) 6.7 (2.5) and Nback was 4.7 (2.9) (p... (More)

Background and purpose — Indication for lumbar disc herniation (LDH) surgery is usually to relieve sciatica. We evaluated whether back pain also decreases after LDH surgery. Patients and methods — In the Swedish register for spinal surgery (SweSpine) we identified 14,097 patients aged 20–64 years, with pre- and postoperative data, who in 2000–2016 had LDH surgery. We calculated 1-year improvement on numeric rating scale (rating 0–10) in back pain (Nback) and leg pain (Nleg) and by negative binomial regression relative risk (RR) for gaining improvement exceeding minimum clinically important difference (MCID). Results — Nleg was preoperatively (mean [SD]) 6.7 (2.5) and Nback was 4.7 (2.9) (p < 0.001). Surgery reduced Nleg by mean 4.5 (95% CI 4.5–4.6) and Nback by 2.2 (CI 2.1–2.2). Mean reduction in Nleg) was 67% and in Nback 47% (p < 0.001). Among patients with preoperative pain ≥ MCID (that is, patients with significant baseline pain and with a theoretical possibility to improve above MCID), the proportion who reached improvement ≥ MCID was 79% in Nleg and 60% in Nback. RR for gaining improvement ≥ MCID in smokers compared with non-smokers was for Nleg 0.9 (CI 0.8–0.9) and ­Nback 0.9 (CI 0.8–0.9), and in patients with preoperative duration of back pain 0–3 months compared with > 24 months for Nleg 1.3 (CI 1.2–1.5) and for Nback 1.4 (CI 1.2–1.5). Interpretation — LDH surgery improves leg pain more than back pain; nevertheless, 60% of the patients with significant back pain improved ≥ MCID. Smoking and long duration of pain is associated with inferior recovery in both Nleg and Nback.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica
volume
92
issue
1
pages
4 - 8
publisher
Taylor & Francis
external identifiers
  • scopus:85090317067
  • pmid:32896198
ISSN
1745-3674
DOI
10.1080/17453674.2020.1815981
language
English
LU publication?
yes
id
de78b46c-834f-4e52-9535-e6f1db56950f
date added to LUP
2021-01-08 14:28:35
date last changed
2024-06-13 04:26:50
@article{de78b46c-834f-4e52-9535-e6f1db56950f,
  abstract     = {{<p>Background and purpose — Indication for lumbar disc herniation (LDH) surgery is usually to relieve sciatica. We evaluated whether back pain also decreases after LDH surgery. Patients and methods — In the Swedish register for spinal surgery (SweSpine) we identified 14,097 patients aged 20–64 years, with pre- and postoperative data, who in 2000–2016 had LDH surgery. We calculated 1-year improvement on numeric rating scale (rating 0–10) in back pain (N<sub>back</sub>) and leg pain (N<sub>leg</sub>) and by negative binomial regression relative risk (RR) for gaining improvement exceeding minimum clinically important difference (MCID). Results — N<sub>leg</sub> was preoperatively (mean [SD]) 6.7 (2.5) and N<sub>back</sub> was 4.7 (2.9) (p &lt; 0.001). Surgery reduced N<sub>leg</sub> by mean 4.5 (95% CI 4.5–4.6) and N<sub>back</sub> by 2.2 (CI 2.1–2.2). Mean reduction in N<sub>leg</sub>) was 67% and in N<sub>back</sub> 47% (p &lt; 0.001). Among patients with preoperative pain ≥ MCID (that is, patients with significant baseline pain and with a theoretical possibility to improve above MCID), the proportion who reached improvement ≥ MCID was 79% in N<sub>leg</sub> and 60% in N<sub>back</sub>. RR for gaining improvement ≥ MCID in smokers compared with non-smokers was for N<sub>leg</sub> 0.9 (CI 0.8–0.9) and ­N<sub>back</sub> 0.9 (CI 0.8–0.9), and in patients with preoperative duration of back pain 0–3 months compared with &gt; 24 months for N<sub>leg</sub> 1.3 (CI 1.2–1.5) and for N<sub>back</sub> 1.4 (CI 1.2–1.5). Interpretation — LDH surgery improves leg pain more than back pain; nevertheless, 60% of the patients with significant back pain improved ≥ MCID. Smoking and long duration of pain is associated with inferior recovery in both N<sub>leg</sub> and N<sub>back</sub>.</p>}},
  author       = {{Hareni, Niyaz and Strömqvist, Fredrik and Strömqvist, Björn and Sigmundsson, Freyr Gauti and Rosengren, Björn E. and Karlsson, Magnus K.}},
  issn         = {{1745-3674}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{4--8}},
  publisher    = {{Taylor & Francis}},
  series       = {{Acta Orthopaedica}},
  title        = {{Back pain is also improved by lumbar disc herniation surgery}},
  url          = {{http://dx.doi.org/10.1080/17453674.2020.1815981}},
  doi          = {{10.1080/17453674.2020.1815981}},
  volume       = {{92}},
  year         = {{2021}},
}