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European Spine Journal

, Volume 19, Issue 9, pp 1459–1467 | Cite as

Clinical factors of importance for outcome after lumbar disc herniation surgery: long-term follow-up

  • Katarina SilverplatsEmail author
  • B. Lind
  • B. Zoëga
  • K. Halldin
  • M. Gellerstedt
  • H. Brisby
  • L. Rutberg
Original Article

Abstract

Factors as age, sex, smoking, duration of leg pain, working status, type/level of disc herniation and psychosocial factors have been demonstrated to be of importance for short-term results after lumbar discectomy. There are few studies with long-term follow-up. In this prospective study of lumbar disc herniation patients undergoing surgery, the result was evaluated at 2 and 5–10 (mean 7.3) years after surgery. Predictive factors for satisfaction with treatment and objective outcome were investigated. Out of the included 171 patients undergoing lumbar discectomy, 154 (90%) patients completed the 2-year follow-up and 140 (81%) completed the long-term follow-up. Baseline data and questionnaires about leg- and back pain intensity (VAS), duration of leg pain, disability (Oswestry Disability Index), depression (Zung Depression Scale), sick leave and employment status were obtained preoperatively, at 2-year- and long-term follow-up. Primary outcome included patient satisfaction with treatment (at both time points) and assessment of an independent observer at the 2-year follow-up. Secondary outcomes at 2-year follow-up were improvement of leg and back pain, working capacity and the need for analgesics or sleeping pills. In about 70% of the patients excellent or good overall result was reported at both follow-ups, with subjective outcome measurements. The objective evaluation after 2 years was in agreement with this result. Time on sick leave was found to be a clinically important predictor of the primary outcomes, with a potential of changing the probability of a satisfactory outcome (both objective and subjective) from around 50% (sick leave >3 months) to 80% (sick leave <2 months). Time on sick leave was also an important predictor for several of the secondary outcomes; e.g. working capacity and the need for analgesics.

Keywords

Disc herniation Surgery Long-term follow-up Clinical outcome Predictive factor 

Notes

Acknowledgments

The study was supported with grants from Marianne och Marcus Wallenberg’s Foundation, ALF Västra Götaland, Gothenburg Medical association, The Swedish Society of Medicine and the The Neubergh Foundation.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Katarina Silverplats
    • 1
    Email author
  • B. Lind
    • 1
  • B. Zoëga
    • 2
  • K. Halldin
    • 1
  • M. Gellerstedt
    • 3
  • H. Brisby
    • 1
  • L. Rutberg
    • 4
  1. 1.Department of OrthopaedicsSahlgrenska University Hospital, Göteborg UniversityGothenburgSweden
  2. 2.Department of OrthopaedicsLandspitali University HospitalReykjavikIceland
  3. 3.Department of OrthopaedicsTrollhättan/Uddevalla UniversityUddevallaSweden
  4. 4.Department of NeurologySahlgrenska University HospitalGothenburgSweden

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