Health-related quality of life in patients with surgically treated lumbar disc herniation

Abstract

Background and purpose Health-related quality of life (HRQoL) instruments have been of increasing interest for evaluation of medical treatments over the past 10–15 years. In this prospective, long-term follow-up study we investigated the influence of preoperative factors and the change in HRQoL over time after lumbar disc herniation surgery.Methods 117 patients surgically treated for lumbar disc herniation (L4-L5 or L5-S1) were evaluated with a self-completion HRQoL instrument (EQ-5D) preoperatively, after 2 years (96 patients) and after 7 years (89 patients). Baseline data (age, sex, duration of leg pain, surgical level) and degree of leg and back pain (VAS) were obtained preoperatively. The mean age was 39 (18–66) years, 54% were men, and the surgical level was L5-S1 in 58% of the patients. The change in EQ-5D score at the 2-year follow-up was analyzed by testing for correlation and by using a multiple regression model including all baseline factors (age, sex, duration of pain, degree of leg and back pain, and baseline EQ-5D score) as potential predictors.Results 85% of the patients reported improvement in EQ-5D two years after surgery and this result remained at the long-term follow-up. The mean difference (change) between the preoperative EQ-5D score and the 2-year and 7-year scores was 0.59 (p < 0.001) and 0.62 (p < 0.001), respectively. However, the HRQoL for this patient group did not reach the mean level of previously reported values for a normal population of the same age range at any of the follow-ups. The changes in EQ-5D score between the 2- and 7-year follow-ups were not statistically significant (mean change 0.03, p = 0.2). There was a correlation between baseline leg pain and the change in EQ-5D at the 2-year (r = 0.33, p = 0.002) and 7-year follow-up (r = 0.23, p = 0.04). However, when using regression analysis the only statistically significant predictor for change in EQ-5D was baseline EQ-5D score.Interpretation Our findings suggest that HRQoL (as measured by EQ-5D) improved 2 years after lumbar disc herniation surgery, but there was no further improvement after 5 more years. Low quality of life and severe leg pain at baseline are important predictors of improvement in quality of life after lumbar disc herniation surgery.

The Quality of Life in Patients After Surgical Treatment of a Lumbar Disc Herniation — a Preliminary Study

“…Studies conducted by many authors [6,12,14,15] showed that patients with a herniated disc in lumbo -sacral region experienced pain sensations of a medium intensity which was confirmed by own study. However, postoperative pain sensation is reduced [5,6,14,[16][17][18] as was also confirmed by this study.…”

“…Studies conducted by other authors confirm the positive effect of surgery on the quality of life in patients who underwent surgery [3,[16][17][18]20]. In this study, the evaluation of functional condition of patients was made with the use of ODI.…”

Physical prognostic factors predicting outcome following lumbar discectomy surgery: systematic review and narrative synthesis

“…The most common physical prognostic factor that was investigated in 5 studies [34-37, 39-41] was pre-operative duration of leg pain, followed by intensity of pre-operative leg pain investigated in 3 studies [36][37][38]41], and pre-operative back pain investigated in 2 studies [36,37,41].…”

“…Pre-operative duration of leg pain was included in 5 studies [34][35][36][37][38][39]41] as a candidate prognostic factor. There were inconsistencies regarding the association between the duration of pre-operative leg pain and numerous outcomes.…”

Efectos de una intervención quirúrgica menor sobre la calidad de vida en niños desde diferentes perspectivas

“…Consta de una escala analógica visual que abarca una puntuación de 0 a 100, siendo 0 el peor estado de salud y 100 el mejor estado, e incluye cinco dimensiones, que son movilidad, autocuidado, actividades de la vida diaria, dolor/malestar y ansiedad/depresión. Cada dimensión tiene tres posibles respuestas o niveles de problema que presentan en esa dimensión (ausencia que se codifica con 1, moderado que se codifica con 2 o grave que se codifica con 3) 24 . El niño debe marcar el nivel de problemas, dentro de cada dimensión, que mejor describa su estado de salud en ese día.…”