This article is more than 5 years old. Information may no longer be current.
Spine register officials: Lumbar disc herniation surgery positively affects quality of life
Click Here to Manage Email Alerts
 Peter Fritzell |
GOTHENBURG, Sweden — Identifying and treating patients with lumbar disc herniations within 3 months of the onset of their condition may substantially help their surgical outcomes, according to a register-based study presented here at the International Society for the Study of the Lumbar Spine Annual Meeting 2011.
For those patients in Sweden operated on for lumbar disc herniation (LDH) and tracked in Swespine — Sweden’s national spine register — using the EQ-5D, “We increase quality of life from 0.25 to 0.7 and this is in approximately 9,000 patients, so [these are] real life figures,” Peter Fritzell, MD, of the orthopaedic department at Falun Hospital in Sweden, said during his presentation.
From the time Swespine began 15 years ago through 2008, 9,245 Swedish patients operated on for LDHs have been tracked in the register. This latest analysis mainly focused on the register’s key 1-year findings, according to Fritzell, but he also reported a few 2-year and 5-year LDH results. Among them, surgery fared well in terms of addressing leg pain.
“We improved leg pain in our patients from approximately 65 on the VAS scale to 20. You have to remember that this is a degenerative condition and we don’t cure our patients,” Fritzell said.
Preoperative duration of leg pain was a predictor of outcome in the study. Prior to surgery, LDH patients with leg pain lasting less than 3 months had worse overall pain compared with those with leg pain lasting longer than 12 months, but at 1 postoperative year those with the shorter duration of pain had improved the most.
“This is also the same at 2 years,” Fritzell said.
When Fritzell and colleagues analyzed other typical predicators of outcome for these patients with respect to their leg pain and global assessments, including smoking status, procedure volume, gender and whether traditional or microsurgical techniques were used, volume mattered when the cut-off point was 20 cases and 31% of smokers were dissatisfied with their surgical result vs. 21% of nonsmokers. Following a multivariate regression analysis, only leg pain duration remained a key predictor of a favorable outcome.
This has implications for patient selection, according to Fritzell.
“This register has shown us that we are doing a lot of good. We are approximately reaching the same success levels as our colleagues who are operating for hip surgery and knee surgery,” he said.
Reference:
- Fritzell P, Strömquist B, Jönsson B, Hägg O. Prediction of outcome after surgery for lumbar disc herniation in Sweden – Analysis of data from Swespine — The national spine register. Paper #P39. Presented at the International Society for the Study of the Lumbar Spine Annual Meeting 2011. June 14-18. Gothenburg, Sweden.
Follow
OrthoSuperSite.com on Twitter