Introduction: Majority of patients with sciatica caused by lumbar disc herniation (LDH) have a positive clinical course and good recovery after non-surgical treatment. Those patients treated surgically usually have good results in first few years of follow-up. A number of patients anyhow have minimal or no improvement after surgery and many factors have been studied on having importance for this type of outcome after LDH surgery.
Aim: To analyze different demographic, clinical, radiological, social and other factors and their relation with outcome and pre-treatment patients’ expectations of LDH surgery.
Material and methods: We retrospectively analyzed group of 99 patients surgically treated in our institution in last two years for sciatica caused by single level unilateral disc herniation. All patients underwent interhemilaminectomy and microdiscectomy. We analyzed demographic data, clinical findings and social factors. We assessed degeneration of paraspinal muscles, intervertebral discs and facet joints, pre-treatment expectations of surgery. Outcome was assessed with standardized instruments.
Results: A total of 99 patients have been included and followed for nine months in average (6-18 months). 63,6% of patients were male and 36,4 were female, average age 45,7±12,4 years. Average duration of complaints was 145±220 days and the most common complaints were pain (91%) and motor deficit (48,5%). The most commonly affected level was L4-L5 (57,6%). Straight leg raising test was positive in 70% of patients. Expectations of successful spinal surgery was present in 89% of patients, and was not depending on their education. 75,8% of patients were satisfied with results of treatment.
Conclusion: We need new studies including larger number of patients and analyzing much more potentially influencing factors for LDH surgery outcome in order to minimize number of unsatisfied patients.