The Influence of Surgical Treatment on Reported Ailments and Neurological Status of Patients with Spine Discopathy
Keywords
discopathy, assessment, pain, neurological statusAbstract
Introduction. Treatment of patients with spine discopathy is the subject of interest in numerous medical disciplines and includes non-invasive as well as invasive methods. Both therapeutic ways aim to resolve the disc-root conflict. The clinical picture and the incidence of neurological complications depend on the location of herniated nucleus pulposus.
Aim. To determine the influence of surgical treatment on reported ailments and neurological status of patients with spine discopathy.
Material and Methods. The study was conducted twice (before and after the surgery) among 188 patients treated surgically due to cervical or lumbosacral spine discopathy. The analysis included: clinical and intraoperative diagnosis, the level of operation, BMI, and neurological status: Laseque’s sign, muscle strength, pain, dysesthesia, sphincter disorders. The results were analyzed by means of Microsoft Excel spreadsheet and Statistica 6.0, assuming a significance level of p≤ 0.05.
Results. While assessing pain, in the case of L-S discopathy, the majority of patients belonged to group III (34%) and group IV (33.5%). After the operation, 37.8% of patients were classified as group II; in cervical discopathy this percentage was 12.2%. The positive Laseque’s sign before the operation was observed in 68.1% of the subjects; after the surgery in 56%.
Dysesthesia in the case of the upper discopathy occurred in 72.9% of the patients, after the surgery in 30.3% (p <0.05).
Conclusions. Performed surgery significantly results in reducing pain in patients. The improvement was also noticed in neurological status. (JNNN 2015;4(3):109–116)
References
Philips F.M., Slosar P.J., Youssef J.A., Andersson G., Papatheofanis F. Lumbar spine fusion for chronic low back pan due to degenerative disc disease: a systematic review. Spine. 2013;38(7):E409-422.
Lamella J., Whitaker M.C., Moskowitz A., et al. Stand-alone anterior lumbar interbody fusion for degenerative disc disease of the lumbar spine: results with a 2-year follow-up. Spine. 2014;39(15):E894-901.
Petersilge C.A. Lumbar disc replacement. Seminars in Musculoskeletal Radiology. 2006;10(1):22-29.
Summers B., Malhan K., Cassar-Pullicino V. Low back pain on passive straight leg raising: the anterior theca as a source of pain. Spine. 2005;30(3):342-345.
Williams F.M., Sambrook PN. Neck and back pain and intervertebral disc degeneration: role of occupational factors. Best Practice & Research Clinical Rheumatology. 2011;25(1):69-79.
Rubin D.I. Epidemiology and risk factors for spine pain. Neurologic Clinics. 2007;25(2):353-371.
Xin Z.Q., Zhao L., Wang J.W., Tang Y. Progressing study in treating discogenic low back pain. Zhongguo Gu Shang. 2009;22(4):320-323.
Petersen T., Olsen S., Laslett M., Thorsen H. Inter-tester reliability of a new diagnostics classification system for patients with non-specific low back pain. Australian Journal of Physiotherapy. 2004;50(2):85-94.
Wenger M., Markwalder T.M. A novel surgical treatment
of lumbag disco herniation in atients with long - standing degenerative disc disease. Journal of Neurosurgery: Spine. 2003;28:391-395.
Radziszewski R.K. Analiza porównawcza stanu neurologicznego chorych na dyskopatię kręgosłupa lędźwiowego leczonych zachowawczo lub operacyjnie. Polski Merkuriusz Lekarski. 2007;22(129):186–191.
Storm P.B., Chou D., Tamarg R.J. Surgical management of cervical and lumbosacral radiculopathies: indications and outcomes. Physical Medicine and Rehabilitation Clinics of North America. 2002;13:235- 259.
McGirt M.J., Ambrossi G.L., Datoo G., et al. Recurrent disc herniation and long - term back pain after primary lumbar discectomy: review of outcomes reported for limited versus aggressive disc removal. Neurosergery. 2009;64(2):338-344.
Watters W.C., McGirt M.J. An evidence - based review of the literature on the consequences of conservative versus aggressive discectomy for the treatment of primary disc herniation with radiculopathy. The Spine Journal. 2009;9(3):240–257.
Mulleman D., Mammou S., Griffoul I. Pathophysiology
of disk-related sciatica. I evidence supporting a chemical component. Joint Bone Spine. 2006;(73):151-158.
Sheehan N.J. Magnetic resonance imaging for low back pain: indications and limitations. Annals of the
Rheumatic Diseases. 2010;69(1):7-11.
Jaskólski D.J. Zespoły objawowe powstające z uwięźnięcia. W: Kozubski W., Liberski P. (Red.),
Neurologia. PZWL, Warszawa 2008;657–682.
Kerr D., Zhao W., Lurie JD. What ar long-term predictors of outcomes for lumbar disc herniation?
A randomized and observational study. Clinical Orthopaedics and Related Research. 2015;473(6):1920-
Kohlboeck G., Greimel K.V., Piotrowski W.P. et al. Prognosis of multifactorial outcome in lumbar discectomy:
a prospective longitudinal study investigating patients with lumbar disc prolapse. The Clinical Journal of Pain. 2004;20(6):455-461.
Lovett R.W. The treatment of infantile paralysis 2nd ed.: Blakinston´s Son. Philadelphia 1917.
Manniche C., Asmussen K., Lauritens B., Vinterberg H., Kreiner S., Jordan A. Low back pain rating
scale: validation of a tool for assassment of low back pain. Pain. 1994;(57),317-326.
Ahmed M., Modic M.T. Neck and low back pain: neuroimaging. Neurologic Clinics. 2007;25:439-471.
Radziszewski K.R. Porównawcza retrospektywna analiza dolegliwości bólowych u chorych na
dyskopatię lędźwiową leczonych zachowawczo lub operacyjnie. Polski Merkuriusz Lekarski. 2006;21(124):335-340.
Borenstein D.G. Epidemiology, etiology diagnostics evaluation, and treatment of low back pain. Current
Opinion in Rheumatology. 2001;13(2):128-134.
Cȏtë P., Cassidy J. D., Carroll L. The epidemiology of neck pain: what we have learned from our population
- based studies. The Journal of the Canadian Chiropractic Association. 2003;47(4):284–290.
Mannion A.F., Balagué F., Pellisé F., Cedraschi C. Pain measurement in patients with low
back pain. Nature Clinical Practice Rheumatology. 2007,3(11):610-618.
Suk K. S., Lee H. M., Moon S.W., Kim N.H. Recurrent lumbar disc herniation: Results of operative
management. Spine. 2001;26(6):672-676.
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(6):652-657.
Ryang Y.M., Oertel M.F., Mayfrank L., Gilsbach J.M., Rohde V. Standard open microdiscectomy
versus minimal access trocar microdiscectomy: results of a prospective randomised study. Neurosergery.
;62(1):174-182.
Godlewski B., Grochal M., Jekimov R., Wójcik R., Radek M., Radek A. Evaluation of outcome after
surgical treatment of cervical disc disease with Dero C - Disc Peek cages. Neurologia i Neurochirurgia Polska.
;41(4):417-426.
Dewing C.B., Provencher M.T., Riffenburgh R.H., Kerr S., Manos R. E. The outcomes of lumbar
microdiscectomy in a young, active population: correlation by herniation type and level. Spine.
;33(1):33-38.
Selkowitz D.M., Kulig K., Poppert E.M., et al. The immediate and long - term effects of exercise
and patient education on physical, functional, and quality - of - life outcome measures after single -
level lumbar microdiscectomy: a randomized controlled trial protocol. BMC Musculoskelet Disorder.
;25(7):70.
Peul W.C., van Houwelingen H.C., van den Hout W.B., et al. Leiden - the hague spine intervention
prognostic study group.: Surgery versus prolonged conservative treatment for sciatica. Nederlands Tijdschrift
voor Geneeskunde. 2007;31(356):2245–2256.
Jankowski R., Blok T., Piestrzeniewicz R., Żukiel R., Czekanowska-Szlandrowicz R., Moskal J.
Wskazania do operacji i wyniki leczenia przepukliny krążka międzykręgowego w odcinku lędźwiowo
- krzyżowym kręgosłupa. Neuroskop. 2003; 1(5):43-50.
Rebain R., Baxter G.D., McDonough S. A systematic review of the passive straight leg raising test
as a diagnostic aid for low back pain (1989 to 2000). Spine. 2002;27 (17):388-395.
Summers B., Malhan K., Cassar - Pullicino V. Low back pain on passive straight leg raising: the anterior
theca as a source of pain. Spine. 2005;30(3):342-345.
Iglesias-Casarrubios P., Alday-Anzola R., Ruíz -López P., Gómez-López P., Cruz-Bértolo J., Lobato
R.D. Lasegue’s test as prognostic factor for patients undergoing lumbar disc surgery. Neurocirurgia.
;15(2):138-143.
Epstein N.E. A review of laminoforaminotomy for the management of lateral and foraminal cervical
disc herniations or spurs. Surgical Neurology. 2002;(57):226-234.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Stats
Number of views and downloads: 146
Number of citations: 0