PMID- 17545909
OWN - NLM
STAT- MEDLINE
DCOM- 20070627
LR  - 20220331
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 32
IP  - 13
DP  - 2007 Jun 1
TI  - Outcome evaluation of surgical and nonsurgical management of lumbar disc 
      protrusion causing radiculopathy.
PG  - 1414-22
AB  - STUDY DESIGN: Prospective cohort study. OBJECTIVE: To assess health-related 
      quality of life (HRQOL) following either lumbar discectomy or nonoperative care 
      for lumbar disc protrusion causing radiculopathy (LDPR). SUMMARY OF BACKGROUND 
      DATA: Although LDPR is a prevalent disorder, little progress has been made in 
      defining the optimal treatment strategy. METHODS: A total of 497 patients (333 in 
      the lumbar discectomy group and 164 in the nonoperative group) were analyzed. 
      Patients completed baseline as well as 6- and 12-month generic (SF-36) and 
      disease-specific (NASS Lumbar Spine Instrument) HRQOL measures. Demographic 
      comparisons between groups, using standard descriptive statistics, were made. 
      Multivariate analysis was used to obtain a regression coefficient for the primary 
      outcome: the neurogenic symptoms score (NSS) from the NASS instrument. Outcome 
      measures were compared between groups and to published normative data. RESULTS: 
      The mean baseline score was lower in the surgical group (30.9 nonoperative, 25.3 
      surgical), indicative of greater baseline disability. The scores at follow-up 
      were approximately equivalent (44.6 nonoperative, 43.8 surgical). However, 
      neither group returned to an age-matched normative NSS (51.6) within the 
      timeframe of the study. Using regression analysis, the outcome "change in NSS" 
      was not associated with variable "treatment group." CONCLUSIONS: HRQOL after 
      LDPR, as measured in this study by NASS NSS, demonstrated similar improvement in 
      both groups and was not meaningfully associated with the treatment received, 
      within the timeframe of this study. At follow-up, all outcome measures remained 
      lower than population normative scores, suggesting that, irrespective of 
      treatment, an element of disability remained.
FAU - Thomas, Kenneth C
AU  - Thomas KC
AD  - Department of Surgery (Orthopedics) and Neurosciences, University of Calgary, 
      Calgary, AB, Canada.
FAU - Fisher, Charles G
AU  - Fisher CG
FAU - Boyd, Michael
AU  - Boyd M
FAU - Bishop, Paul
AU  - Bishop P
FAU - Wing, Peter
AU  - Wing P
FAU - Dvorak, Marcel F
AU  - Dvorak MF
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
MH  - Adult
MH  - Disability Evaluation
MH  - Diskectomy/methods
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Intervertebral Disc Displacement/complications/*surgery/*therapy
MH  - Linear Models
MH  - Lumbar Vertebrae/*surgery
MH  - Male
MH  - Middle Aged
MH  - Pain, Postoperative
MH  - Prospective Studies
MH  - Quality of Life
MH  - Radiculopathy/etiology/*surgery/*therapy
MH  - Treatment Outcome
EDAT- 2007/06/05 09:00
MHDA- 2007/06/28 09:00
CRDT- 2007/06/05 09:00
PHST- 2007/06/05 09:00 [pubmed]
PHST- 2007/06/28 09:00 [medline]
PHST- 2007/06/05 09:00 [entrez]
AID - 00007632-200706010-00009 [pii]
AID - 10.1097/BRS.0b013e318060a5d1 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2007 Jun 1;32(13):1414-22. doi: 
      10.1097/BRS.0b013e318060a5d1.