Sunset Chiropractic & Wellness Research Review: Pain Recurrence after Discectomy for Symptomatic Lumbar Disc Herniation
Risk of leg pain recurrence:
● 1 year = 20%
● 3 years = 45%
Risk of Low back pain recurrence:
● 1 year = 29%
● 3 years = 65%
www.ncbi.nlm.nih.gov/pmc/articles/PMC5332353/#:~:text=Recurrent%20pain%20after%20lumbar%20discectomy,from%20the%20intervertebral%20disc1.
Objective
To determine risks and predictors of recurrent pain following standard open discectomy for subacute/chronic symptomatic lumbar disc herniation (SLDH).
Summary of Background Data
Sunset Chiropractic & Wellness Research Review: Pain Recurrence after Discectomy for Symptomatic Lumbar Disc Herniation.
Most prior studies of recurrence after discectomy do not explicitly define pain resolution and recurrence, and do not account for variable durations of time at-risk for recurrence.
Methods
We used survival analysis methods to examine predictors of leg pain recurrence. For individuals with initial resolution of leg pain, we defined recurrent leg pain as having leg pain, receiving lumbar epidural steroid injections, or undergoing lumbar surgery subsequent to initial leg pain resolution. We calculated cumulative risks of leg pain recurrence using Kaplan-Meier survival curves, and examined predictors of recurrence using Cox proportional hazards models. We used similar methods to examine LBP recurrence.
Results
1- and 3-year cumulative risks of leg pain recurrence were 20% and 45%, respectively. 1- and 3- year leg pain recurrence risks were substantially lower in participants with complete initial resolution of leg pain (17% and 41%, respectively) than in those without (27% and 54%, respectively). In multivariate analyses, complete leg pain resolution (adjusted hazard ratio [aHR] 0.69 [95% CI 0.52-0.90]), smoking (aHR 1.68 [95% CI 1.22-2.33]), and depression (aHR 1.74 [95% CI 1.18-2.56]) predicted leg pain recurrence. The 1- and 3-year risk of LBP recurrence was 29% and 65%, respectively. LBP recurrence risk at 3 years was substantially lower in participants with complete initial resolution of LBP than in those without, but not at 1 year.
Conclusions
Recurrence of leg pain and LBP is common after discectomy for SLDH. Cumulative risks of both leg pain and LBP recurrence were generally lower in participants achieving complete initial resolution of pain post-discectomy.
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Sunset Chiropractic & Wellness Research Review: Pain Recurrence after Discectomy for Symptomatic Lumbar Disc Herniation.
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Dr. Mark N. Berry, D.C.
Sunset Chiropractic and Wellness
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