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Review paper

Comparison of early and delayed lumbar disc herniation surgery and the treatment outcome

By
Ermin Hadžić Orcid logo ,
Ermin Hadžić
Contact Ermin Hadžić

Division of Neurosurgery, Cantonal Hospital “Dr. Safet Mujić”, Mostar, Bosnia and Herzegovina

Bruno Splavski ,
Bruno Splavski

Department of Neurosurgery, ''Sestre milosrdnice'' University Hospital Centre, Zagreb, Croatia

School of Medicine,

School of Dental Medicine and Health, University "Josip Juraj Strossmayer" Osijek, Osijek, Croatia

University of Applied Health Sciences, Zagreb, Zagreb, Croatia

Goran Lakičević
Goran Lakičević

Department of Neurosurgery, University Clinical Hospital, Mostar, Bosnia and Herzegovina

Abstract

Aim
To evaluate the influence of preoperative symptoms duration on surgical outcome of one-level lumbar disc herniation surgery.
Methods
In a prospective randomized study, 67 adult patients with one-level lumbar disc herniation were analysed. The patients
whose duration of symptoms was <6 months were included in the case group, while those with the duration of symptoms ˃6 months formed the control group. The investigated preoperative variables were: pain intensity in the back and legs (Visual Analogue Scale - VAS), Sciatica Bothersomeness Index (SBI), index of disability (Oswestry Disability Index - ODI). Postoperative variables were: pain intensity in the back and legs (VAS), SBI, ODI, and outcome according to the Odom’s criteria (excellent, good, satisfactory and poor). Significance level was set at p <0.05.
Results
A statistically significant difference was recorded between the groups, showing a better decrease of radicular pain intensity
and sciatica bothersome, as well as patients disability in the case group (p<0.001). According to the Odom’s criteria the outcome was better in the case group, since the difference between the groups was statistically significant too (p<0.05).
Conclusion
Early lumbar disc herniation surgery performed within the first 6 months from the start of symptoms is beneficial due to decreases of radicular pain intensity, sciatica bothersomeness, and patient’s disability. 

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