Lumbar degeneration and quality of life in patients with lumbar disc herniation: a case-control long-term follow-up study
Background and purpose: Adults treated surgically for lumbar disc herniation in adolescence have a higher degree of lumbar disc degeneration than controls. We aimed to establish whether the degree of lumbar degeneration differs at diagnosis or at follow-up between surgically and non-surgically trea...
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2024-02-01
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| Series: | Acta Orthopaedica |
| Subjects: | |
| Online Access: | https://actaorthop.org/actao/article/view/39944 |
| _version_ | 1797333081316655104 |
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| author | Sebastian Pontén Tobias Lagerbäck Sebastian Blomé Karin Jensen Mikael Skorpil Paul Gerdhem |
| author_facet | Sebastian Pontén Tobias Lagerbäck Sebastian Blomé Karin Jensen Mikael Skorpil Paul Gerdhem |
| author_sort | Sebastian Pontén |
| collection | DOAJ |
| description |
Background and purpose: Adults treated surgically for lumbar disc herniation in adolescence have a higher degree of lumbar disc degeneration than controls. We aimed to establish whether the degree of lumbar degeneration differs at diagnosis or at follow-up between surgically and non-surgically treated individuals.
Methods: We identified individuals with a lumbar disc herniation in adolescence diagnosed with magnetic resonance imaging (MRI) and contacted them for follow-up MRI. Lumbar degeneration was assessed according to Pfirrmann, Modic, and total end plate score (TEP score). Patient-reported outcome measures at follow-up comprised the Oswestry Disability Index (ODI), EQ-5D-3-level version, 36-Item Short Form Health Survey (SF-36), and Visual Analogue Scale (VAS) for back and leg pain. Fisher’s exact test, Mann–Whitney U tests, Wilcoxon tests, and logistic regression were used for statistical analysis.
Results: MRIs were available at diagnosis and after a mean of 11.9 years in 17 surgically treated individuals and 14 non-surgically treated individuals. Lumbar degeneration was similar at diagnosis (P = 0.2) and at follow-up, with the exception of higher TEP scores in surgically treated individuals at levels L4–L5 and L5–S1 at follow-up (P ≤ 0.03), but this difference did not remain after adjustment for age and sex (P ≥ 0.8). There were no significant differences in patient-reported outcome measures between the groups at follow-up (all P ≥ 0.2).
Conclusion: Adolescents with a lumbar disc herniation have, irrespective of treatment, a similar degree of lumbar degeneration at the time of diagnosis, and similar lumbar degeneration and patient-reported outcomes at long-term follow-up.
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| first_indexed | 2024-03-08T07:58:39Z |
| format | Article |
| id | doaj.art-63d7c236275d4353bde43d290cacc1f9 |
| institution | Directory Open Access Journal |
| issn | 1745-3674 1745-3682 |
| language | English |
| last_indexed | 2024-03-08T07:58:39Z |
| publishDate | 2024-02-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj.art-63d7c236275d4353bde43d290cacc1f92024-02-02T13:07:28ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822024-02-019510.2340/17453674.2024.39944Lumbar degeneration and quality of life in patients with lumbar disc herniation: a case-control long-term follow-up studySebastian Pontén0Tobias Lagerbäck1Sebastian Blomé2Karin Jensen3Mikael Skorpil4Paul Gerdhem5Department of Orthopaedics and Hand Surgery, Uppsala University Hospital, Uppsala; Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, StockholmDepartment of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, StockholmDepartment of Clinical Neuroscience, Division of Neuro, Karolinska Institutet, StockholmDepartment of Clinical Neuroscience, Division of Neuro, Karolinska Institutet, StockholmDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm; Department of Neuroradiology, Karolinska University Hospital, StockholmDepartment of Orthopaedics and Hand Surgery, Uppsala University Hospital, Uppsala; Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden Background and purpose: Adults treated surgically for lumbar disc herniation in adolescence have a higher degree of lumbar disc degeneration than controls. We aimed to establish whether the degree of lumbar degeneration differs at diagnosis or at follow-up between surgically and non-surgically treated individuals. Methods: We identified individuals with a lumbar disc herniation in adolescence diagnosed with magnetic resonance imaging (MRI) and contacted them for follow-up MRI. Lumbar degeneration was assessed according to Pfirrmann, Modic, and total end plate score (TEP score). Patient-reported outcome measures at follow-up comprised the Oswestry Disability Index (ODI), EQ-5D-3-level version, 36-Item Short Form Health Survey (SF-36), and Visual Analogue Scale (VAS) for back and leg pain. Fisher’s exact test, Mann–Whitney U tests, Wilcoxon tests, and logistic regression were used for statistical analysis. Results: MRIs were available at diagnosis and after a mean of 11.9 years in 17 surgically treated individuals and 14 non-surgically treated individuals. Lumbar degeneration was similar at diagnosis (P = 0.2) and at follow-up, with the exception of higher TEP scores in surgically treated individuals at levels L4–L5 and L5–S1 at follow-up (P ≤ 0.03), but this difference did not remain after adjustment for age and sex (P ≥ 0.8). There were no significant differences in patient-reported outcome measures between the groups at follow-up (all P ≥ 0.2). Conclusion: Adolescents with a lumbar disc herniation have, irrespective of treatment, a similar degree of lumbar degeneration at the time of diagnosis, and similar lumbar degeneration and patient-reported outcomes at long-term follow-up. https://actaorthop.org/actao/article/view/39944Disc herniationPaediatric orthopaedicsRadiological imagingSpine |
| spellingShingle | Sebastian Pontén Tobias Lagerbäck Sebastian Blomé Karin Jensen Mikael Skorpil Paul Gerdhem Lumbar degeneration and quality of life in patients with lumbar disc herniation: a case-control long-term follow-up study Acta Orthopaedica Disc herniation Paediatric orthopaedics Radiological imaging Spine |
| title | Lumbar degeneration and quality of life in patients with lumbar disc herniation: a case-control long-term follow-up study |
| title_full | Lumbar degeneration and quality of life in patients with lumbar disc herniation: a case-control long-term follow-up study |
| title_fullStr | Lumbar degeneration and quality of life in patients with lumbar disc herniation: a case-control long-term follow-up study |
| title_full_unstemmed | Lumbar degeneration and quality of life in patients with lumbar disc herniation: a case-control long-term follow-up study |
| title_short | Lumbar degeneration and quality of life in patients with lumbar disc herniation: a case-control long-term follow-up study |
| title_sort | lumbar degeneration and quality of life in patients with lumbar disc herniation a case control long term follow up study |
| topic | Disc herniation Paediatric orthopaedics Radiological imaging Spine |
| url | https://actaorthop.org/actao/article/view/39944 |
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