Predictive value of the duration of sciatica for lumbar discectomy. A prospective cohort study.
The optimum timing of lumbar discectomy for sciatica is imprecise. We have investigated a number of prognostic factors in relation to the outcome of radiculopathy after lumbar discectomy. We recruited 113 consecutive patients of whom 103 (91%) were followed up at one year. We found a significant association between the duration of radiculopathy and the changes in the Oswestry Disability Index score (p = 0.005) and the low back outcome score (p = 0.03). Improvement in pain was independent of all variables. Patients with an uncontained herniated disc had a shorter duration of symptoms and a better functional outcome than those with a contained herniation. Our study suggests that patients with sciatica for more than 12 months have a less favourable outcome. We detected no variation in the results for patients operated on in whom the duration of sciatica was less than 12 months.
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Leicester General Hospital, Leicester, England, UK.
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D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D017586:Diskectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011379:Prognosis; D011446:Prospective Studies; D012585:Sciatica / Q000209:etiology / Q000601:surgery*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome