Abstract
Purpose
Prospectively evaluate the timescale of leg pain resolution after lumbar discectomy and decompression, in the immediate post-operative period and identify possible risk factors for failure/delay in leg pain resolution.
Materials and Methods
A prospective observational study of 100 consecutive patients undergoing lumbar discectomy or decompression. Patients recorded their leg and back pain in VAS and disability in ODI preoperatively. Patients rated their leg pain relief just prior to discharge after surgery. Telephone follow-up at 1-2 week and 3-4 week post-op was followed by clinic review at 6 and 12 weeks, to assess the timescale of leg pain resolution and improvement in function (ODI score).
Results
Immediately before discharge from hospital 67% patients reported relief of leg pain. 33% reported no relief or were unsure. Of these, 26 (80%) reported pain relief subsequently. At 1-2 weeks, 81 patients reported pain relief. 14 reported persistent pain, but six of them (45%) improved subsequently. By six weeks 91% reported leg pain relief and only two of the unimproved nine patients subsequently experienced relief of leg pain. Failure to improve the leg pain was clearly associated with failure to improve disability by ODI score. But the ODI score did not improve in 11 patients reporting relief of leg pain. Decompression in older age and women had a relatively higher risk of poor result.
Conclusion
After lumbar discectomy and decompression, leg pain relief is immediate in 67%, in 81% by one week and in 91% by six weeks. Improvement is unlikely after this period. Non-resolution of leg pain resulted in persistent/worsened disability, but 11% patients did not improve functionally despite experiencing leg pain relief. Decompression, older age and female sex were negative risk factors.
