Severe sciatica: a 13-year follow-up of 342 patients.
This study involved 342 patients hospitalized because of severe, persistent sciatica suggestive of a lumbar intervertebral disc herniation. After standard clinical evaluation, EMG and myelography, 220 patients underwent lumbar discectomy. The remaining 122 patients were treated conservatively. Follow-up examinations were arranged after 1, 5 and 13 years. The study focused on the rehabilitation outcome in general and differences in outcome between the two treatment groups. Several indicators showed a rather poor outcome for sciatica patients during the 13-year follow-up period. In the operated group 16% had been re-operated because of lumbar disc herniation. True recurrence of herniation (same level and side) occurred in 8%. In the conservatively treated group 14% had undergone spinal surgery. Nearly 70% of the patients still reported sciatica. Self-assessed levels of low back pain were "no change/worse" for 19% in the operated group and for 44% in the conservatively treated group. In both the study groups, nearly 40% of the subjects had retired on disability pensions.
Nykvist
F
F
Research and Development Centre of the Social Insurance Institution, Turku, Finland.
Hurme
M
M
Alaranta
H
H
Kaitsaari
M
M
D000203:Activities of Daily Living; D000328:Adult; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000534:rehabilitation / Q000601:surgery; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D011184:Postoperative Period; D012179:Retirement; D012585:Sciatica / Q000209:etiology / Q000601:surgery*; D012907:Smoking; D013131:Spine / Q000601:surgery*