Conservative Treatment of Lumbar Disc Herniation - A Prospective Study of Disc Herniation Encroaching More than One-third of Spinal Canal -

Shin, Byung-Joon; Lee, Jae Chul; Lee, Ho-Hyoung; Jang, Hae‐Dong

doi:10.4184/jkss.2011.18.3.123

Cited by 2 publications

(1 citation statement)

References 23 publications

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“…Some studies investigated the effectiveness of conservative treatment of spinal pain and diversity of physical therapy methods. Shin et al 27) reported that the clinical results of conservative treatment in patients with more than one-third spinal canal encroachment were satisfactory. Patients who underwent thermal mineral water therapy showed improvements in VAS for pain, ODI, EQ-5D, and SF-36 29) .…”

Section: Discussionmentioning

confidence: 99%

Spinal Injections Versus Conservative Treatment for Spinal Pain: The Korean Spine Patient Outcomes Research Trial (K‐SPORT) Observational Cohort

et al. 2020

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Objective: Spinal injections are increasingly used in the treatment of spinal pain, but its efficacy has been criticized. The purpose of this study was to compare the treatment effects of spinal injections and conservative care. Methods: This is a prospective observational cohort of nonsurgical candidates with spinal pain who were treated in one institute. Spinal injections included conventional injections, such as epidural steroid injection, selective nerve root block, medial branch block, interlaminar epidural block, caudal block, and sacroiliac joint block, and percutaneous epidural neuroplasty. Conservative treatment included medications, physical therapy, and exercise. Results: Primary outcome measures were changes from baseline in the visual analogue scale of lower back and leg pain (VAS_back and VAS_leg, respectively), 36-item Short Form Survey (SF-36), Euro Quality of Life-5 Dimensions (EQ-5D), and Oswestry Disability Index (ODI) at 1, 3, and 6 months. Secondary outcome that served as measure of clinical success was 50% (or 4-point) reduction from baseline VAS_back or VAS_leg and no increase from baseline ODI and SF-36 or 30% (or 2-point) reduction from baseline VAS_back or VAS_leg with 30% (or 3-point) reduction in ODI from baseline or 30% (or 20-point) increase from baseline SF-36. Of the 142 patients followed up to 6 months, 47 patients underwent spinal injection and 95 patients underwent conservative treatment. The initial VA_leg, EQ-5D_mobility, EQ-5D_pain/discomfort, and SF-36_bodily pain was higher in the injection group (p=0.0309, p=0.0258, p=0.0042, and p=0.0474 respectively). In both groups, spinal pain significantly decreased at 1-month follow-up, and the effect was maintained for 6 months (p<0.001). At all follow-up periods, there was no difference in the clinical success between the spinal injection and conservative treatment groups. Conclusion: The treatment effect was not different according to the diagnosis or disease severity. Both treatments were equally effective in carefully selected patients with spinal pain.

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Section: Discussionmentioning

confidence: 99%

Spinal Injections Versus Conservative Treatment for Spinal Pain: The Korean Spine Patient Outcomes Research Trial (K‐SPORT) Observational Cohort

et al. 2020

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Relative Risk of Operation between Lumbar Far Lateral Disc Herniation and Posterolateral Disc Herniation: A Retrospective Cohort Study

Shim

Kim

et al. 2017

J Korean Orthop Assoc

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Purpose:We reported relative risk of operation between patients who were diagnosed with lumbar far lateral disc herniation and posterolateral disc herniation after transforaminal epidural block. Materials and Methods: A retrospective cohort study was performed on 295 patients (131 male and 164 female) who underwent transforaminal epidural block for unilateral radiculopathy caused by lumbar intervertebral disc herniation. Among these 295 patients, 34 patients were diagnosed with far lateral disc herniation and 261 patients with posterolateral disc herniation. The median follow-up period was 23.9 months, with an average age of 55.7 years. Results: Fifty-one patients underwent surgical treatment. Among them, 38 patients had posterolateral disc herniation and 13 patients had far lateral disc herniation. Patients with far lateral disc herniation, when compared with posterolateral disc herniation, had a relative risk of operation of 2.67 (1.59-4.48, 95% confidence interval) with statistical significance (p=0.0002). At the final follow-up, the average visual analogue scale (VAS) score for radicular pain in the surgical and non-surgical groups was 0.69 and 1.50, respectively; the average KoreanOswestry Disability Questionnaire (K-ODI) score was 11.7 and 9.6, respectively. The difference of average VAS score showed a statistical significance (p=0.035), however, that of K-ODI showed no statistical significance (p=0.266). Conclusion: In the case of far lateral disc herniation, the relative risk of surgery after transforaminal epidural block was 2.67, which is higher than that of posterolateral disc herniation. Therefore, we should consider surgical treatment more aggressively.

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Conservative Treatment of Lumbar Disc Herniation - A Prospective Study of Disc Herniation Encroaching More than One-third of Spinal Canal -

Cited by 2 publications

References 23 publications

Spinal Injections Versus Conservative Treatment for Spinal Pain: The Korean Spine Patient Outcomes Research Trial (K‐SPORT) Observational Cohort

Spinal Injections Versus Conservative Treatment for Spinal Pain: The Korean Spine Patient Outcomes Research Trial (K‐SPORT) Observational Cohort

Relative Risk of Operation between Lumbar Far Lateral Disc Herniation and Posterolateral Disc Herniation: A Retrospective Cohort Study

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