[The functional status in patients with discopathy of the lumbar spine receiving only conservative therapy or operative therapy].
Discopathy of lumbar spine inevitably leads to decreased quality of life in patients. Decrease of the backbone dysfunction at the degree which makes leading a life close to the normal style of family, social and professional life impossible, is the key therapeutic task. Evaluation of the functional disability can be the objective method of evaluation of the treatment efficacy. The purpose of this study was to analyze of the functional state in patients with lumbar discopathy receiving either conservative therapy only or surgical treatment.


METHODS
665 patients aged between 16 and 76 years with discopathy at L4-L5, L5-S1 levels have been enrolled into the study. In analyzed group 348 patients received only a conservative therapy whereas 317 patients underwent an operative procedure. Analysis has been performed based on four rating scores for evaluation of the functional status: Low Back Pain Rating Scale, Functional-Economic Outcome Rating Scale of Prolo, Oswestry Low Back Pain Disability Questionnaire, Low-Back Outcome Score.


RESULTS
In preliminary examination approx. 40% decrease in parameters of evaluation of the functional status has been found in the group of patients receiving conservative therapy. Functional status of the patients within more than 10-year period of treatment was sufficiently stable and tended to progression in distant study. Ability to perform daily life activities was the strongest determined by backbone and limb pains as well as by the level of neurological deficits. In preliminary examination approx. 45% decrease in parameters of evaluation of the functional status has been found in the group of operated patients. Functional status significantly improved within immediate period post surgery.


CONCLUSIONS
1. Functional status in patients with discopathy of the lumbar spine in basic degree is determined by neurological status and intensification of the pain afflictions. 2. The operative intervention brings essential improvement of the patients' functional status. 3. Functional status deteriorates within subsequent years of the treatment; it is determined in greater degree by the age of patients than by treatment method.
Radziszewski
Krzysztof R
KR
Kliniki Rehabilitacji Wojskowego Szpitala Klinicznego w Bydgoszczy. radziszewski@wp.pl
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D018450:Disease Progression; D017586:Diskectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007403:Intervertebral Disc / Q000503:physiopathology / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000503:physiopathology* / Q000628:therapy*; D008159:Lumbar Vertebrae / Q000503:physiopathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D016896:Treatment Outcome