Residual Symptoms After Lumbar Discectomy

From those lovely people who gave us the SPORT studies comes another analysis of the data. This time they looked at recurrence of low back pain and leg pain 1 and 3 years after a lumbar discectomy for sciatica

See the article abstract or source the article here

But basically the results were:

1 and 3-year cumulative risks of leg pain recurrence were 20% and 45%, respectively. 1 and 3- year leg pain recurrence risks were substantially lower in participants with complete initial resolution of leg pain (17% and 41%, respectively) than in those without (27% and 54%, respectively). In multivariate analyses, complete leg pain resolution (adjusted hazard ratio [aHR] 0.69; 95% confidence interval [CI] 0.52–0.90), smoking (aHR 1.68 [95% CI 1.22–2.33]), and depression (aHR 1.74 [95% CI 1.18–2.56]) predicted leg pain recurrence. The 1- and 3-year risk of LBP recurrence was 29% and 65%, respectively. LBP recurrence risk at 3 years was substantially lower in participants with complete initial resolution of LBP than in those without, but not at 1 year.

Now it is good to place this in context by looking at the SPORT studies (if you haven’t read up on the SPORT studies you should, its all about surgical vs non-surgical management of lumbar radiculopathy, due to disc herniation or spondylolisthesis, and neurogenic claudication due to lumbar stenosis). The group operated on had to undergo at least 6 weeks of non-surgical management and if they had no improvement in symptoms they were eligible for going into either go into the surgical or non-surgical management arms of the trial.

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