LOW-BACK PAIN FOLLOWING SURGERY FOR LUMBAR DISC HERNIATION
A Prospective Study
– Tomoaki Toyone, MD, Tadashi Tanaka, MD, Daisuke Kato, MD and Ryutaku Kaneyama, MD
Lumbar disc herniation often causes sciatica. Although surgery may provide relief of sciatic pain, it is uncertain how surgery affects the relief of low-back pain. The purpose of the present prospective study was to assess the efficacy of discectomy in the treatment of low-back pain associated with lumbar disc herniation.
Excision of a herniated disc for relief of sciatica provided rapid relief of sciatica and low-back pain. The findings of the present small study suggest that lumbar disc herniation might be a possible cause of low-back pain.
In one study, excision of a herniated disc provided rapid relief of sciatica in eight-six of eighty-seven selected patients.1
However, relief of low-back pain has been far less predictable. The purpose of the present prospective study was to examine patients with lumbar disc herniation and to evaluate the change in low-back pain after surgery on the basis of subjective pain criteria and patient-oriented outcome measures.
Predisposing factors for postoperative disabling low-back pain have been reported to include heavy manual work,2 more than three months of sick leave before hospital admission,3 a cigarette smoking history of more than fifteen pack-years,1 and preoperative advanced disc degeneration.4
Workers’ Compensation patients were excluded from the present study. The exclusion of such patients might have been one of the reasons for the good results that we observed in terms of the relief of low-back pain.
- Hanley EN Jr., Shapiro DE. The development of low-back pain after excision of a lumbar disc. J Bone Joint Surg AM. 1989;71:719-21.
- Loupasis GA, Stamos K, Katonis PG, Sapkas G, Korres DS, Hartofilakidis G. Seven- to 20-year outcome of lumbar discectomy. Spine. 1999;24:2313-7.
- Weber H. Lumbar disc herniation. A controlled, prospective study with ten years of observation. Spine. 1983;8:131-40.
- Yorimitsu E, Chiba K, Toyama Y, Hirabayashi K. Long-term outcomes of standard discectomy for lumbar disc herniation: a follow-up study of more than 10 years. Spine. 2001;26:652-7.