Our Summary

This research paper is about a study that was conducted to understand the effect of a surgical procedure called discectomy on patients with lumbar disc herniation, a condition where the cushion between the bones in your lower back gets damaged.

The two main things the study looked at were changes in the height of the disc in the lower back and changes in the pain scores (how much pain patients felt) before and after the surgery.

After analyzing the data from 18 different studies involving 893 patients, the researchers found that the surgery led to a significant reduction in the height of the disc (by about 14.4%) and also a significant decrease in the pain scores. They also observed a connection between the reduction in the disc height and the decrease in back pain scores. However, they could not establish a significant relationship between changes in disc height index (another measure of disc height) and changes in clinical pain scores.

In simpler terms, the study found that this surgery does lead to a decrease in the size of the disc and also less pain for the patients. The decrease in the size of the disc was also linked to the decrease in back pain. But they couldn’t find a clear link between changes in another measure of disc height and changes in pain scores.

The researchers believe that more studies are needed to fully understand these results and to help doctors explain to their patients what to expect before the surgery.

FAQs

  1. What is the impact of discectomy on disc height in lumbar disc herniation patients?
  2. Is there a relationship between the reduction in disc height and the decrease in back pain scores post discectomy?
  3. Is there a significant relationship between disc height index change and decrease in clinical pain scores after discectomy surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about discectomy is to understand that the surgery may result in a reduction in disc height, which can contribute to a decrease in back pain. It is important to discuss this potential outcome with your healthcare provider and follow any post-operative recommendations for optimal recovery.

Suitable For

Patients with lumbar disc herniation (LDH) who are experiencing significant back pain and/or leg pain that does not improve with conservative treatments such as physical therapy, medications, and injections are typically recommended for discectomy surgery. Additionally, patients with severe neurological symptoms such as weakness, numbness, or tingling in the legs may also be candidates for discectomy. It is important for patients to consult with their healthcare provider to determine if discectomy is the appropriate treatment option for their specific condition.

Timeline

Before discectomy:

  1. Patient experiences back and/or leg pain due to lumbar disc herniation.
  2. Patient may undergo conservative treatments such as physical therapy, medication, and injections to manage symptoms.
  3. If symptoms persist or worsen, patient may be recommended for discectomy surgery.

After discectomy:

  1. Patient undergoes discectomy surgery to remove the herniated disc material pressing on the nerves.
  2. Following surgery, there is a statistically significant reduction in disc height and disc height index.
  3. The reduction in disc height is associated with a decrease in back pain scores post-surgery.
  4. Further studies are needed to improve understanding and preoperative counseling for patients undergoing discectomy surgery.

What to Ask Your Doctor

  1. How will discectomy surgery impact my disc height?
  2. What is the typical amount of disc height reduction seen in patients following discectomy?
  3. Will the reduction in disc height affect my overall spine alignment or stability?
  4. Is there a correlation between disc height reduction and pain relief post-surgery?
  5. Are there any potential long-term implications of disc height reduction following discectomy?
  6. How soon after surgery can I expect to see improvements in my pain scores?
  7. Are there any specific exercises or therapies I should consider to help maintain disc height post-surgery?
  8. How often will I need follow-up imaging to monitor changes in disc height?
  9. Are there any factors that may increase the risk of disc height reduction following discectomy surgery?
  10. What are the potential benefits and risks of undergoing discectomy surgery for my specific case of lumbar disc herniation?

Reference

Authors: Chen X, Sandhu HS, Vargas Castillo J, Diwan AD. Journal: Eur Spine J. 2021 Nov;30(11):3265-3277. doi: 10.1007/s00586-021-06891-4. Epub 2021 Jun 10. PMID: 34114106