PMID- 32896198
OWN - NLM
STAT- MEDLINE
DCOM- 20210308
LR  - 20211216
IS  - 1745-3682 (Electronic)
IS  - 1745-3674 (Print)
IS  - 1745-3674 (Linking)
VI  - 92
IP  - 1
DP  - 2021 Feb
TI  - Back pain is also improved by lumbar disc herniation surgery.
PG  - 4-8
LID - 10.1080/17453674.2020.1815981 [doi]
AB  - 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(back)) and leg 
      pain (N(leg)) and by negative binomial regression relative risk (RR) for gaining 
      improvement exceeding minimum clinically important difference (MCID).Results - 
      N(leg) was preoperatively (mean [SD]) 6.7 (2.5) and N(back) was 4.7 (2.9) (p < 
      0.001). Surgery reduced N(leg) by mean 4.5 (95% CI 4.5-4.6) and N(back) by 2.2 
      (CI 2.1-2.2). Mean reduction in N(leg)) was 67% and in N(back) 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 N(leg) and 60% in N(back). 
      RR for gaining improvement >/= MCID in smokers compared with non-smokers was for 
      N(leg) 0.9 (CI 0.8-0.9) and -N(back) 0.9 (CI 0.8-0.9), and in patients with 
      preoperative duration of back pain 0-3 months compared with > 24 months for 
      N(leg) 1.3 (CI 1.2-1.5) and for N(back) 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(leg) and N(back).
FAU - Hareni, Niyaz
AU  - Hareni N
AD  - Department of Orthopaedics, Varberg Hospital, Varberg.
AD  - Departments of Clinical Sciences and Orthopedics, Lund University, Skane 
      University Hospital, Malmo, Sweden.
FAU - Stromqvist, Fredrik
AU  - Stromqvist F
AD  - Departments of Clinical Sciences and Orthopedics, Lund University, Skane 
      University Hospital, Malmo, Sweden.
FAU - Stromqvist, Bjorn
AU  - Stromqvist B
AD  - Departments of Clinical Sciences and Orthopedics, Lund University, Skane 
      University Hospital, Malmo, Sweden.
FAU - Sigmundsson, Freyr Gauti
AU  - Sigmundsson FG
AD  - Department of Orthopedics, School of Medical Sciences, Faculty of Medicine and 
      Health, Orebro University, Orebro, Sweden.
FAU - Rosengren, Bjorn E
AU  - Rosengren BE
AD  - Departments of Clinical Sciences and Orthopedics, Lund University, Skane 
      University Hospital, Malmo, Sweden.
FAU - Karlsson, Magnus K
AU  - Karlsson MK
AD  - Departments of Clinical Sciences and Orthopedics, Lund University, Skane 
      University Hospital, Malmo, Sweden.
LA  - eng
PT  - Journal Article
DEP - 20200908
PL  - Sweden
TA  - Acta Orthop
JT  - Acta orthopaedica
JID - 101231512
RN  - Intervertebral disc disease
SB  - IM
MH  - Adult
MH  - Back Pain/*surgery
MH  - Female
MH  - Humans
MH  - Intervertebral Disc Degeneration/*surgery
MH  - Intervertebral Disc Displacement/*surgery
MH  - Lumbar Vertebrae/*surgery
MH  - Male
MH  - Middle Aged
MH  - Pain Measurement
MH  - Sciatica/*surgery
MH  - Surveys and Questionnaires
MH  - Young Adult
PMC - PMC7919903
EDAT- 2020/09/09 06:00
MHDA- 2021/03/09 06:00
PMCR- 2020/09/08
CRDT- 2020/09/08 08:45
PHST- 2020/09/09 06:00 [pubmed]
PHST- 2021/03/09 06:00 [medline]
PHST- 2020/09/08 08:45 [entrez]
PHST- 2020/09/08 00:00 [pmc-release]
AID - 1815981 [pii]
AID - 10.1080/17453674.2020.1815981 [doi]
PST - ppublish
SO  - Acta Orthop. 2021 Feb;92(1):4-8. doi: 10.1080/17453674.2020.1815981. Epub 2020 
      Sep 8.