Characteristics of relief and residual low back pain after discectomy in patients with lumbar disc herniation: analysis using a detailed visual analog scale
Abstract Background Several authors have reported favorable results in low back pain (LBP) for patients with lumbar disc herniation (LDH) treated with discectomy. However, detailed changes over time in the characteristics and location of LBP before and after discectomy for LDH remain unclear. To cla...
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-02-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-021-04015-z |
| _version_ | 1819176670331928576 |
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| author | Hiroshi Takahashi Yasuchika Aoki Masahiro Inoue Junya Saito Arata Nakajima Masato Sonobe Yorikazu Akatsu Keita Koyama Yasuhiro Shiga Kazuhide Inage Yawara Eguchi Sumihisa Orita Satoshi Maki Takeo Furuya Tsutomu Akazawa Tetsuya Abe Toru Funayama Hiroshi Noguchi Kousei Miura Kentaro Mataki Yosuke Shibao Fumihiko Eto Mamoru Kono Masao Koda Masashi Yamazaki Seiji Ohtori Koichi Nakagawa |
| author_facet | Hiroshi Takahashi Yasuchika Aoki Masahiro Inoue Junya Saito Arata Nakajima Masato Sonobe Yorikazu Akatsu Keita Koyama Yasuhiro Shiga Kazuhide Inage Yawara Eguchi Sumihisa Orita Satoshi Maki Takeo Furuya Tsutomu Akazawa Tetsuya Abe Toru Funayama Hiroshi Noguchi Kousei Miura Kentaro Mataki Yosuke Shibao Fumihiko Eto Mamoru Kono Masao Koda Masashi Yamazaki Seiji Ohtori Koichi Nakagawa |
| author_sort | Hiroshi Takahashi |
| collection | DOAJ |
| description | Abstract Background Several authors have reported favorable results in low back pain (LBP) for patients with lumbar disc herniation (LDH) treated with discectomy. However, detailed changes over time in the characteristics and location of LBP before and after discectomy for LDH remain unclear. To clarify these points, we conducted an observational study to determine the detailed characteristics and location of LBP before and after discectomy for LDH, using a detailed visual analog scale (VAS) bilaterally. Methods We included 65 patients with LDH treated by discectomy in this study. A detailed VAS for LBP was administered with the patient under 3 different conditions: in motion, standing, and sitting. Bilateral VAS was also administered (affected versus opposite side) for LBP, lower extremity pain (LEP), and lower extremity numbness (LEN). The Oswestry Disability Index (ODI) was used to quantify clinical status. Changes over time in these VAS and ODI were investigated. Pfirrmann grading and Modic change as seen by magnetic resonance imaging (MRI) were reviewed before and 1 year after discectomy to determine disc and endplate condition. Results Before surgery, LBP on the affected side while the patients were in motion was significantly higher than LBP while they were sitting (p = 0.025). This increased LBP on the affected side in motion was improved significantly after discectomy (p < 0.001). By contrast, the residual LBP while sitting at 1 year after surgery was significantly higher than the LBP while they were in motion or standing (p = 0.015). At 1 year following discectomy, residual LBP while sitting was significantly greater in cases showing changes in Pfirrmann grade (p = 0.002) or Modic type (p = 0.025). Conclusions Improvement of LBP on the affected side while the patient is in motion suggests that radicular LBP is improved following discectomy by nerve root decompression. Furthermore, residual LBP may reflect increased load and pressure on the disc and endplate in the sitting position. |
| first_indexed | 2024-12-22T21:14:27Z |
| format | Article |
| id | doaj.art-af562b98f37544df9f16f02d452baa17 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-22T21:14:27Z |
| publishDate | 2021-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-af562b98f37544df9f16f02d452baa172022-12-21T18:12:25ZengBMCBMC Musculoskeletal Disorders1471-24742021-02-012211910.1186/s12891-021-04015-zCharacteristics of relief and residual low back pain after discectomy in patients with lumbar disc herniation: analysis using a detailed visual analog scaleHiroshi Takahashi0Yasuchika Aoki1Masahiro Inoue2Junya Saito3Arata Nakajima4Masato Sonobe5Yorikazu Akatsu6Keita Koyama7Yasuhiro Shiga8Kazuhide Inage9Yawara Eguchi10Sumihisa Orita11Satoshi Maki12Takeo Furuya13Tsutomu Akazawa14Tetsuya Abe15Toru Funayama16Hiroshi Noguchi17Kousei Miura18Kentaro Mataki19Yosuke Shibao20Fumihiko Eto21Mamoru Kono22Masao Koda23Masashi Yamazaki24Seiji Ohtori25Koichi Nakagawa26Department of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Eastern Chiba Medical CenterDepartment of Orthopaedic Surgery, Eastern Chiba Medical CenterDepartment of Orthopaedic Surgery, Toho University Sakura Medical CenterDepartment of Orthopaedic Surgery, Toho University Sakura Medical CenterDepartment of Orthopaedic Surgery, Toho University Sakura Medical CenterDepartment of Orthopaedic Surgery, Toho University Sakura Medical CenterDepartment of Orthopaedic Surgery, Toho University Sakura Medical CenterDepartment of Orthopaedic Surgery, Chiba University Graduate School of MedicineDepartment of Orthopaedic Surgery, Chiba University Graduate School of MedicineDepartment of Orthopaedic Surgery, Chiba University Graduate School of MedicineDepartment of Orthopaedic Surgery, Chiba University Graduate School of MedicineDepartment of Orthopaedic Surgery, Chiba University Graduate School of MedicineDepartment of Orthopaedic Surgery, Chiba University Graduate School of MedicineDepartment of Orthopaedic Surgery, St. Marianna University School of MedicineDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Chiba University Graduate School of MedicineDepartment of Orthopaedic Surgery, Toho University Sakura Medical CenterAbstract Background Several authors have reported favorable results in low back pain (LBP) for patients with lumbar disc herniation (LDH) treated with discectomy. However, detailed changes over time in the characteristics and location of LBP before and after discectomy for LDH remain unclear. To clarify these points, we conducted an observational study to determine the detailed characteristics and location of LBP before and after discectomy for LDH, using a detailed visual analog scale (VAS) bilaterally. Methods We included 65 patients with LDH treated by discectomy in this study. A detailed VAS for LBP was administered with the patient under 3 different conditions: in motion, standing, and sitting. Bilateral VAS was also administered (affected versus opposite side) for LBP, lower extremity pain (LEP), and lower extremity numbness (LEN). The Oswestry Disability Index (ODI) was used to quantify clinical status. Changes over time in these VAS and ODI were investigated. Pfirrmann grading and Modic change as seen by magnetic resonance imaging (MRI) were reviewed before and 1 year after discectomy to determine disc and endplate condition. Results Before surgery, LBP on the affected side while the patients were in motion was significantly higher than LBP while they were sitting (p = 0.025). This increased LBP on the affected side in motion was improved significantly after discectomy (p < 0.001). By contrast, the residual LBP while sitting at 1 year after surgery was significantly higher than the LBP while they were in motion or standing (p = 0.015). At 1 year following discectomy, residual LBP while sitting was significantly greater in cases showing changes in Pfirrmann grade (p = 0.002) or Modic type (p = 0.025). Conclusions Improvement of LBP on the affected side while the patient is in motion suggests that radicular LBP is improved following discectomy by nerve root decompression. Furthermore, residual LBP may reflect increased load and pressure on the disc and endplate in the sitting position.https://doi.org/10.1186/s12891-021-04015-zLumbar disc herniationResidual low back painVisual analog scaleRadicular low back pain |
| spellingShingle | Hiroshi Takahashi Yasuchika Aoki Masahiro Inoue Junya Saito Arata Nakajima Masato Sonobe Yorikazu Akatsu Keita Koyama Yasuhiro Shiga Kazuhide Inage Yawara Eguchi Sumihisa Orita Satoshi Maki Takeo Furuya Tsutomu Akazawa Tetsuya Abe Toru Funayama Hiroshi Noguchi Kousei Miura Kentaro Mataki Yosuke Shibao Fumihiko Eto Mamoru Kono Masao Koda Masashi Yamazaki Seiji Ohtori Koichi Nakagawa Characteristics of relief and residual low back pain after discectomy in patients with lumbar disc herniation: analysis using a detailed visual analog scale BMC Musculoskeletal Disorders Lumbar disc herniation Residual low back pain Visual analog scale Radicular low back pain |
| title | Characteristics of relief and residual low back pain after discectomy in patients with lumbar disc herniation: analysis using a detailed visual analog scale |
| title_full | Characteristics of relief and residual low back pain after discectomy in patients with lumbar disc herniation: analysis using a detailed visual analog scale |
| title_fullStr | Characteristics of relief and residual low back pain after discectomy in patients with lumbar disc herniation: analysis using a detailed visual analog scale |
| title_full_unstemmed | Characteristics of relief and residual low back pain after discectomy in patients with lumbar disc herniation: analysis using a detailed visual analog scale |
| title_short | Characteristics of relief and residual low back pain after discectomy in patients with lumbar disc herniation: analysis using a detailed visual analog scale |
| title_sort | characteristics of relief and residual low back pain after discectomy in patients with lumbar disc herniation analysis using a detailed visual analog scale |
| topic | Lumbar disc herniation Residual low back pain Visual analog scale Radicular low back pain |
| url | https://doi.org/10.1186/s12891-021-04015-z |
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