Mehdi Nikoobakht1, Mir Saeed Yekanineajd2, Amir H Pakpour3, Peter C Gerszten4, Richard Kasch5. 1. Department of Neurosurgery, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran. 2. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 3. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Shahid Bahounar BLV, 3419759811, Qazvin, Islamic Republic of Iran; Department of Public Health, Qazvin University of Medical Sciences, Qazvin, Islamic Republic of Iran. Electronic address: Pakpour_Amir@yahoo.com. 4. Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. 5. Clinic and Outpatient Clinic for Orthopedics and Orthopedic Surgery, University Medicine Greifswald, Greifswald, Germany.
Abstract
INTRODUCTION: To evaluate clinical outcomes with PDD as compared with patients who underwent to standard physiotherapy intervention. MATERIAL AND METHODS:One-hundred-seventy-seven randomly assigned patients with primarily radicular pain associated with a single-level lumbar contained disc herniation were enrolled. Participants received either PDD (89 patients) or conservative physiotherapy care (88 patients). RESULTS: Patients in the PDD group had significantly greater reduction in leg pain scores and significantly improved VAS (p<0.001), Oswestry Disability Index (p<0.05), and 36-Item Short Form, than those in the physiotherapy group at 12 months. On subset analysis, patients achieved even better outcomes after PPD who: were younger, had a shorter period of radiculopathy, of male gender, and lower BMI. Patients with subacute pain reported better outcomes than those with chronic pain in the PDD group. CONCLUSIONS: Patient selection for PDD over physiotherapy favored younger patients who presented with a shorter period of pain symptoms and who had a more favorable body habitus.
RCT Entities:
INTRODUCTION: To evaluate clinical outcomes with PDD as compared with patients who underwent to standard physiotherapy intervention. MATERIAL AND METHODS: One-hundred-seventy-seven randomly assigned patients with primarily radicular pain associated with a single-level lumbar contained disc herniation were enrolled. Participants received either PDD (89 patients) or conservative physiotherapy care (88 patients). RESULTS:Patients in the PDD group had significantly greater reduction in leg pain scores and significantly improved VAS (p<0.001), Oswestry Disability Index (p<0.05), and 36-Item Short Form, than those in the physiotherapy group at 12 months. On subset analysis, patients achieved even better outcomes after PPD who: were younger, had a shorter period of radiculopathy, of male gender, and lower BMI. Patients with subacute pain reported better outcomes than those with chronic pain in the PDD group. CONCLUSIONS:Patient selection for PDD over physiotherapy favored younger patients who presented with a shorter period of pain symptoms and who had a more favorable body habitus.