title: Prevalence and severity of preoperative disabilities in Iranian patients with lumbar disc herniation.
abstract: BACKGROUND
  Literature recommends that refractory cases with lumbar disc herniation and appropriate indications are better to be treated surgically, but do all the patients throughout the world consent to the surgery with a same disability and pain threshold? We aim to elucidate the prevalence and severity of disabilities and pain in Iranian patients with lumbar disc herniation who have consented to the surgery.
  
  
  METHODS
  In this case series study, we clinically evaluated 194 (81 female and 113 male) admitted patients with primary, simple, and stable L4-L5 or L5-S1 lumbar disc herniation who were undergoing surgical discectomy. The mean age of the patients was 38.3±11.2 (range: 18-76 years old). Disabilities were evaluated by the items of the Oswestry Disability Index (ODI) questionnaire and severity of pain by the Visual Analogue Scale (VAS). Chi-square test was used to compare the qualitative variables.
  
  
  RESULTS
  Severe disability (39.2%) and crippled (29.9%) were the two most common types of disabilities. Mean ODI score was 56.7±21.1 (range: 16-92). Total mean VAS in all patients was 6.1±1.9 (range: 0-10). Sex and level of disc herniation had no statistical effect on preoperative ODI and VAS. The scale of six was the most frequent scale of preoperative VAS in our patients.
  
  
  CONCLUSIONS
  Iranian patients with lumbar disc herniation who consented to surgery have relatively severe pain or disability. These severities in pain or disabilities have no correlation with sex or level of disc herniation and are not equal with developed countries.
authors.affiliation: Farzad Omidi-Kashani MD, Ebrahim Ghayem Hasankhani MD, Mohammad Hallaj Moghadam MD, Mohammad Sadegh Esfandiari MD, Orthopedic Research Center Department of Orthopedic Surgery Imam Reza Hospital, Faculty of Medicine Mashhad University of Medical Science, Mashhad, Iran.
authors.forename: Farzad
authors.initials: F
authors.lastname: Omidi-Kashani
authors.affiliation: Farzad Omidi-Kashani MD, Ebrahim Ghayem Hasankhani MD, Mohammad Hallaj Moghadam MD, Mohammad Sadegh Esfandiari MD, Orthopedic Research Center Department of Orthopedic Surgery Imam Reza Hospital, Faculty of Medicine Mashhad University of Medical Science, Mashhad, Iran.
authors.forename: Ebrahim Ghayem
authors.initials: EG
authors.lastname: Hasankhani
authors.affiliation: Farzad Omidi-Kashani MD, Ebrahim Ghayem Hasankhani MD, Mohammad Hallaj Moghadam MD, Mohammad Sadegh Esfandiari MD, Orthopedic Research Center Department of Orthopedic Surgery Imam Reza Hospital, Faculty of Medicine Mashhad University of Medical Science, Mashhad, Iran.
authors.forename: Mohammad Hallaj
authors.initials: MH
authors.lastname: Moghadam
authors.affiliation: Farzad Omidi-Kashani MD, Ebrahim Ghayem Hasankhani MD, Mohammad Hallaj Moghadam MD, Mohammad Sadegh Esfandiari MD, Orthopedic Research Center Department of Orthopedic Surgery Imam Reza Hospital, Faculty of Medicine Mashhad University of Medical Science, Mashhad, Iran.
authors.forename: Mohammad Sadegh
authors.initials: MS
authors.lastname: Esfandiari
keywords: Lumbar disc herniation; Oswestry disability index; Visual analogue scale