OBJECTIVES: To determine whether older adults (aged ≥ 60) experience less improvement in disability and pain with nonsurgical treatment of lumbar disk herniation (LDH) than younger adults (< 60). DESIGN: Prospective longitudinal comparative cohort study. SETTING: Outpatient specialty spine clinic. PARTICIPANTS: One hundred thirty-three consecutive patients with radicular pain and magnetic resonance-confirmed acute LDH (89 younger, 44 older). INTERVENTION: Nonsurgical treatment customized for the individual patient. MEASUREMENTS: Patient-reported disability on the Oswestry Disability Index (ODI), leg pain intensity, and back pain intensity were recorded at baseline and 1, 3, and 6 months. The primary outcome was the ODI change score at 6 months. Secondary longitudinal analyses examined rates of change over the follow-up period. RESULTS: Older adults demonstrated improvements in ODI (range 0-100) and pain intensity (range 0-10) with nonsurgical treatment that were not significantly different from those seen in younger adults at 6 month follow-up, with or without adjustment for potential confounders. Adjusted mean improvement in older and younger adults were 31 versus 33 (P = .63) for ODI, 4.5 versus 4.5 (P = .99) for leg pain, and 2.4 versus 2.7 for back pain (P = .69). A greater amount of the total improvement in leg pain and back pain in older adults was noted in the first month of follow-up than in younger adults. CONCLUSION: These preliminary findings suggest that the outcomes of LDH with nonsurgical treatment were not worse in older adults (≥ 60) than in younger adults (< 60). Future research is warranted to examine nonsurgical treatment for LDH in older adults.
OBJECTIVES: To determine whether older adults (aged ≥ 60) experience less improvement in disability and pain with nonsurgical treatment of lumbar disk herniation (LDH) than younger adults (< 60). DESIGN: Prospective longitudinal comparative cohort study. SETTING:Outpatient specialty spine clinic. PARTICIPANTS: One hundred thirty-three consecutive patients with radicular pain and magnetic resonance-confirmed acute LDH (89 younger, 44 older). INTERVENTION: Nonsurgical treatment customized for the individual patient. MEASUREMENTS: Patient-reported disability on the Oswestry Disability Index (ODI), leg pain intensity, and back pain intensity were recorded at baseline and 1, 3, and 6 months. The primary outcome was the ODI change score at 6 months. Secondary longitudinal analyses examined rates of change over the follow-up period. RESULTS: Older adults demonstrated improvements in ODI (range 0-100) and pain intensity (range 0-10) with nonsurgical treatment that were not significantly different from those seen in younger adults at 6 month follow-up, with or without adjustment for potential confounders. Adjusted mean improvement in older and younger adults were 31 versus 33 (P = .63) for ODI, 4.5 versus 4.5 (P = .99) for leg pain, and 2.4 versus 2.7 for back pain (P = .69). A greater amount of the total improvement in leg pain and back pain in older adults was noted in the first month of follow-up than in younger adults. CONCLUSION: These preliminary findings suggest that the outcomes of LDH with nonsurgical treatment were not worse in older adults (≥ 60) than in younger adults (< 60). Future research is warranted to examine nonsurgical treatment for LDH in older adults.
Authors: Molly T Vogt; Peggy Mannen Cawthon; James D Kang; William F Donaldson; Jane A Cauley; Michael C Nevitt Journal: Spine (Phila Pa 1976) Date: 2006-06-01 Impact factor: 3.468
Authors: Pradeep Suri; Adam M Pearson; Emily A Scherer; Wenyan Zhao; Jon D Lurie; Tamara S Morgan; James N Weinstein Journal: PM R Date: 2015-11-06 Impact factor: 2.298
Authors: Pradeep Suri; Ian B Stanaway; Yanfei Zhang; Maxim B Freidin; Yakov A Tsepilov; David S Carrell; Frances M K Williams; Yurii S Aulchenko; Hakon Hakonarson; Bahram Namjou; David R Crosslin; Gail P Jarvik; Ming Ta Lee Journal: Pain Date: 2021-08-01 Impact factor: 7.926