医学
坐骨神经痛
生活质量(医疗保健)
倾向得分匹配
椎间盘切除术
外科
队列
患者满意度
物理疗法
观察研究
腰椎
背痛
内科学
护理部
病理
替代医学
作者
Mikkel Østerheden Andersen,Andreas Killerich Andresen,Leah Y. Carreon,Casper Friis Pedersen
出处
期刊:Spine
[Ovid Technologies (Wolters Kluwer)]
日期:2023-05-03
卷期号:48 (17): 1191-1196
被引量:1
标识
DOI:10.1097/brs.0000000000004692
摘要
Observational study.To identify associations between preoperative symptom duration and postoperative patient satisfaction.Sciatica due to lumbar disk herniation (LDH) is a cause of disability and reduced quality life. Patients with severe pain and disability or were recovery is unacceptably slow, surgical intervention can be advised. For these patients, evidence-based recommendations on the timing of the surgical intervention needs to be established.All patients who underwent discectomy at a Spine Centre, due to radicular pain from June 2010 to May 2019 were included. Pre- and postoperative data including demographic data, smoking, consumption of pain medication, comorbidity, back and leg-pain, health-related quality of life as measured by EQ-5D, ODI, previous spine surgery, sick leave, and duration of back and leg-pain before surgery were utilized. The patients were divided into four groups based on their self-reported duration of leg-pain before surgery. To minimize baseline differences between the groups, propensity-score matching was employed in a 1:1 fashion, balancing the groups on all reported preoperative factors.Of 1607 patients undergoing lumbar discectomy, four matched cohorts based on their self-reported duration of leg-pain before surgery were created. Each cohort consisted of 150 patients well balanced on preoperative factors. Overall 62.7% of the patients were satisfied with the surgical result ranging from 74.0% in the <3 months group to 48.7% in the >24 months group ( P <0.000). The portion of patients achieving a minimum clinically important difference for EQ-5D decreased from 77.4% with early intervention to 55.6% in the late group ( P <0.000). The number of surgical complications were not affected by the duration of preoperative leg-pain.We found significant difference in patient satisfaction and health-related quality of life in patients related to the duration of preoperative leg-pain due to symptomatic LDH.3.
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