The effect of the grade of degenerative changes in the spine on the outcomes of surgery for lumbar discopathy with a radicular syndrome.
BACKGROUND
The aim of the study was an evaluation of the influence of coexisting degenerative changes on surgical outcomes on patients with lumbar disc hernias (DH).


METHODS
A total of randomly selected 132 patients undergoing surgery for DH (classic discectomy with fenestration of the yellow ligament) were examined. Radiographic and MRI scans of the lumbar spine were obtained in all patients, who were subsequently divided into 6 groups depending on the grade and/or extent of degenerative changes. The patients self-evaluated treatment outcomes using a visual analogue scale (VAS). The attending doctors carried out a more detailed assessment of the outcomes by separately determining pain intensity (using a 4-grade scale), motor weakness (using a 3-grade scale) and range of lumbar spine movement (using a 3-grade scale).


RESULTS
In general, patient self-evaluation of treatment outcomes did not reveal statistically significant differences between subgroups. In doctors' detailed assessment, treatment outcomes related to pain and motor weakness were not significantly different between groups with and without spondylosis. The range of motion in the lumbar spine was greater in patients without spondylosis (p<0.05).


CONCLUSIONS
According to both subjective and objective assessments of the therapeutic effects of surgery for lumbar disc hernias, even severe degenerative changes do not worsen the treatment outcome.
Styczyński
Tadeusz
T
Klinika Spondylo-Neurochirurgii i Neurologii, Instytut Reumatologii, Warszawa.
Pyskło
Bohdan
B
Gasik
Robert
R
D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D009068:Movement; D011843:Radiculopathy / Q000601:surgery*; D012720:Severity of Illness Index; D013128:Spinal Osteophytosis / Q000503:physiopathology* / Q000601:surgery; D016896:Treatment Outcome