P Elkan1,2,3, J Sjövie Hasserius4, P Gerdhem4,5. 1. Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-141 86 Stockholm, Sweden. peter.elkan@sodersjukhuset.se. 2. Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, SE-118 83 Stockholm, Sweden. peter.elkan@sodersjukhuset.se. 3. Department of Orthopaedics, Södersjukhuset, SE-118 83 Stockholm, Sweden. peter.elkan@sodersjukhuset.se. 4. Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-141 86 Stockholm, Sweden. 5. Department of Orthopaedics, Karolinska University Hospital, SE-141 86 Stockholm, Sweden.
Abstract
PURPOSE: Surgery for lumbar disc herniation (LDH) is most often elective, but intense pain may require more urgent, non-elective, treatment. It was hypothesized that non-elective treatment could be associated with a less favourable outcome than elective surgery. The aim of this study was to compare 1-2-year outcome after non-elective and elective surgery for treatment of para-median LDH using data from the Swedish Spine register (SweSpine). METHODS: Pre- and postoperative data were available for 301 non-elective and 2364 elective cases. Patient reported outcome measures (PROMs) were; Visual Analogue Scale (VAS) leg and back pain, Oswestry Disability Index (ODI), EuroQol five-Dimensions (EQ-5D) and patient satisfaction. Postoperative p values were adjusted for baseline differences. RESULTS: Preoperative mean (SD) in the non-elective and elective groups were for VAS leg pain 81 (22) and 65 (24), for VAS back pain 51 (33) and 45 (28), for ODI 66 (20) and 45 (17) and for EQ-5D 0.024 (0.35) and 0.31 (0.33), respectively, (p for all <0.001). Postoperative VAS leg pain was 23 (28) in the non-elective group and 20 (26) in the elective group (p = 0.19). Corresponding figures were for VAS back pain 25 (27) and 24 (27) (p = 0.69), ODI 19 (17) and 17 (17) (p = 0.052) and for EQ-5D 0.70 (0.28) and 0.73 (0.29) (p = 0.73). Patient satisfaction did not differ between the groups (p = 0.78). CONCLUSIONS: Even if non-elective patients preoperatively had substantially more pain, higher disability and poorer quality of life than elective patients, postoperative differences were clinically small. Patient satisfaction did not differ.
PURPOSE: Surgery for lumbar disc herniation (LDH) is most often elective, but intense pain may require more urgent, non-elective, treatment. It was hypothesized that non-elective treatment could be associated with a less favourable outcome than elective surgery. The aim of this study was to compare 1-2-year outcome after non-elective and elective surgery for treatment of para-median LDH using data from the Swedish Spine register (SweSpine). METHODS: Pre- and postoperative data were available for 301 non-elective and 2364 elective cases. Patient reported outcome measures (PROMs) were; Visual Analogue Scale (VAS) leg and back pain, Oswestry Disability Index (ODI), EuroQol five-Dimensions (EQ-5D) and patient satisfaction. Postoperative p values were adjusted for baseline differences. RESULTS: Preoperative mean (SD) in the non-elective and elective groups were for VAS leg pain 81 (22) and 65 (24), for VAS back pain 51 (33) and 45 (28), for ODI 66 (20) and 45 (17) and for EQ-5D 0.024 (0.35) and 0.31 (0.33), respectively, (p for all <0.001). Postoperative VAS leg pain was 23 (28) in the non-elective group and 20 (26) in the elective group (p = 0.19). Corresponding figures were for VAS back pain 25 (27) and 24 (27) (p = 0.69), ODI 19 (17) and 17 (17) (p = 0.052) and for EQ-5D 0.70 (0.28) and 0.73 (0.29) (p = 0.73). Patient satisfaction did not differ between the groups (p = 0.78). CONCLUSIONS: Even if non-elective patients preoperatively had substantially more pain, higher disability and poorer quality of life than elective patients, postoperative differences were clinically small. Patient satisfaction did not differ.
Authors: Lars G Johnsen; Christian Hellum; Oystein P Nygaard; Kjersti Storheim; Jens I Brox; Ivar Rossvoll; Gunnar Leivseth; Margreth Grotle Journal: BMC Musculoskelet Disord Date: 2013-04-26 Impact factor: 2.362
Authors: David A T Werner; Margreth Grotle; Sasha Gulati; Ivar M Austevoll; Greger Lønne; Øystein P Nygaard; Tore K Solberg Journal: Eur Spine J Date: 2017-06-14 Impact factor: 3.134
Authors: Thomas C Hydrick; Nicolas Rubel; Sean Renfree; Nina Lara; Justin L Makovicka; Varun Arvind; Michael Chang; Andrew Chung Journal: Global Spine J Date: 2019-11-10