2004
DOI: 10.1007/s00586-004-0721-5
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The risk of ?getting worse? after lumbar microdiscectomy

Abstract: IntroductionLumbar microdiscectomy is the most frequently performed spinal operation. A frequent concern among the patients is the risk of "getting worse" after the operation. It is difficult to give an evidence-based estimate of the risk of deterioration, since previous studies have been more focused on unfavourable outcome in general, rather than on deterioration in particular. Some studies reported on increase in pain after microdiscectomy [17,26,29] and one study reported on decrease in health-related qual… Show more

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Cited by 52 publications
(50 citation statements)
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“…Parallel with consistent findings of pain history as the most powerful predictor for future pain episodes [28], evidence suggests that prior inability to work despite relatively small health problems is a major risk factor for unfavourable work-related outcome after lumbar disk surgery. It follows from here that RTW after treatment for spinal disorder is no specific process and that work-related outcome should be adjusted against prior sick-leave history [97]. A second important consequence is that minor comorbidity factors in some patients might be responsible for delayed RTW that is attributed to recovery from spinal disorder.…”
Section: Discussionmentioning
confidence: 97%
“…Parallel with consistent findings of pain history as the most powerful predictor for future pain episodes [28], evidence suggests that prior inability to work despite relatively small health problems is a major risk factor for unfavourable work-related outcome after lumbar disk surgery. It follows from here that RTW after treatment for spinal disorder is no specific process and that work-related outcome should be adjusted against prior sick-leave history [97]. A second important consequence is that minor comorbidity factors in some patients might be responsible for delayed RTW that is attributed to recovery from spinal disorder.…”
Section: Discussionmentioning
confidence: 97%
“…Indeed, prospective studies focusing on postoperative deterioration of functional status are lacking. This prompted Solberg et al [20] to study the risk of worsening after lumbar microdiscectomy. They prospectively studied 180 patients operated by microdiscectomy for lumbar disc herniation, with a follow-up time of 1 year.…”
Section: Complications Of Surgerymentioning
confidence: 99%
“…I enjoyed the two papers dealing with the outcome after operations by Kara et al [19] and Solberg et al [32].…”
Section: Lumbar Disc Surgery and Spondylolisthesismentioning
confidence: 99%
“…The paper by Solberg et al [32] is also being discussed by Dr. Benoist, but one point I would make is that I was surprised that the authors did not mention the imaging studies. Patients who seem sufficiently disabled to justify surgical treatment, and yet have a small protrusion do less well, and I was surprised that they did not address this (Spengler et al [33]).…”
Section: Lumbar Disc Surgery and Spondylolisthesismentioning
confidence: 99%