Surgery versus nerve block for lumbar disc herniation : quantitative analysis of radiological factors as a predictor for successful outcomes

다국어 초록 (Multilingual Abstract)

Objective: To assess the clinical and radiological factors as predictors for successful outcomes in lumbar disc herniation (LDH) treatment.
Methods: Two groups of patients with single level LDH (L4-5) requiring treatment were studied. The surgery group (SG) included 34 patients, and 30 patients were included in the nerve blocks group (NG). A visual analogue scale (VAS) for leg and back pain and motor deficit were initially evaluated before procedures, and repeated at 1, 6, and 12 months. Radiological factors including the disc herniation length, disc herniation area, canal length-occupying ratio, and canal area-occupying ratio were measured and compared. Predicting factors were determined with multivariate regression after cut off value establishment.
Results: There was no significant demographic difference between two groups. A multivariate logistic regression analysis with radiological and clinical (12 months follow-up) data revealed that the high disc herniation length with cutoff value 6.31mm (odds ratio [OR] 2.35; confidence interval [CI] 1.21-3.98) was a predictor of successful outcomes of leg pain relief in the SG. The low disc herniation length with cutoff value 6.23mm (OR 0.05; CI 0.003-0.89) and high baseline VAS leg (OR 12.63; CI 1.64-97.45) were identified as predictors of successful outcomes of leg pain relief in the NG.
Conclusion: The patients with the disc herniation length larger than 6.31 mm showed successful outcomes with surgery whereas the patients with the disc herniation length less than 6.23 mm showed successful outcomes with nerve block. These results could be considered as a radiological criteria in choosing optimal treatment options for LDH.

목차 (Table of Contents)

• Contents
• I. Introduction ••••••••••••••••••••••••••••••••••••••••••••••••••••••• 1
• II. Materials and methods••••••••••••••••••••••••••••••••••••••••••• 3
• III. Results ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 8
• IV. Discussion •••••••••••••••••••••••••••••••••••••••••••••••••••••• 11
• V. Conclusion •••••••••••••••••••••••••••••••••••••••••••••••••••••• 13
• VI. References ••••••••••••••••••••••••••••••••••••••••••••••••••••• 15
• VII. Figures and Tables ••••••••••••••••••••••••••••••••••••••••••• 19