Disc Herniation Symptom Duration Tied to Outcome

Longer symptom duration tied to worse outcomes, regardless of surgical versus nonsurgical treatment

MONDAY, Oct. 31 (HealthDay News) -- Longer pretreatment symptom duration from lumbar disc herniation is associated with poorer outcomes after both surgical and nonsurgical intervention, according to a study published in the Oct. 19 issue of The Journal of Bone & Joint Surgery.

Jeffrey A. Rihn, M.D., from the Thomas Jefferson University Hospital in Philadelphia, and colleagues analyzed the effects of symptom duration on outcomes following intervertebral lumbar disc herniation treatment. A cohort of 927 patients who experienced symptoms for six months or less was compared to a cohort of 265 patients who experienced more than six months of symptoms. At baseline and at specified intervals for up to four years, treatment outcomes were assessed.

The investigators found that the primary outcome measures were significantly worse for patients who had experienced more than six months of symptoms, at all follow-up intervals, irrespective of whether treatment was surgical or nonsurgical. When comparing the four-year follow-up versus baseline results, both surgically- and nonsurgically-treated patients who had six months or less of symptoms had significantly greater increases in the bodily pain and physical function domains of the Short Form-36, and significantly greater decreases in the Oswestry Disability Index score, compared with patients in the cohort who experienced symptoms for more than six months. The treatment effect differences between the surgical and nonsurgical groups were not significant with respect to symptom duration.

"Increased symptom duration due to lumbar disc herniation is related to worse outcomes following both operative and nonoperative treatment. The relative increased benefit of surgery compared with nonoperative treatment was not dependent on the duration of the symptoms," the authors write.

One or more of the study authors disclosed financial ties to the biomedical industry.

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