Conservative treatment of lumbar disc disease: patient's quality of life compared to an unexposed cohort

The effectiveness of ergonomic interventions in material handling operations

This study evaluated the effectiveness of ergonomic interventions in material handling operations involving 33 employers and 535 employees from 2012 to 2017. Outcomes included employee-reported low back/upper extremity pain and safety incidents at baseline, every three months, and annually for up to two years. A total of 32.5% of employees completed at least one survey, while 13.6% completed all nine surveys over two years. Among highly exposed employees (who reported handling >= 50 lbs. > 33% of the time), upper extremity pain frequency and severity were lower among those who reported using the intervention routinely versus those that reported using their body strength alone to handle objects >= 50 lbs. After excluding from analyses one employer that used anti-fatigue mats, low back pain frequency was also significantly lower among highly exposed intervention users. In conclusion, there was some evidence that the interventions were effective in reducing employee-reported pain for highly exposed employees.

Comparison between Results of Microdiscectomy and Open Discectomy in Management of High-Level Lumbar Disc Prolapse

AIM

This work aims to compare between results of microdiscectomy and open discectomy in management of high-level lumbar disc prolapse.

METHODS

This is a controlled randomised study, where patients having upper lumbar disc herniations were evaluated preoperatively both clinically and radiologically, randomisation was planned to perform open discectomy in odd number patients and to perform microdiscectomy in even number patients, patients were evaluated and followed up for deficits and outcomes.

RESULTS

We operated ten patients in this study, five cases were operated upon with microdiscectomy, and five cases were operated upon with open discectomy, the median age of presentation in this study was 44 years, there were five males and five females, postoperative pain improvement was better in microdiscectomy. Hospital stay, blood loss, bone loss and postoperative complications were less in microdiscectomy.

CONCLUSION

Microdiscectomy allows good surgical visualisation and is less traumatic to the involved tissues. The results of this study indicated that microsurgery reduces hospitalisation time, improves the overall surgery-related outcome. The main differences between the two procedures were the length of the incision and blood loss. We found that lumbar microdiscectomy allows patients earlier return to work and normal life with less reliance on postoperative narcotic analgesic agents.

The quality of life of patients after a lumbar microdiscectomy: a four-year monitoring study

INTRODUCTION/AIM

Health-conditioned quality of patients' life is equally a result of their subjective perception of the disease and their objective condition. The aim of this paper is to evaluate the quality of life of surgically treated lumbar radiculopathy patients by using a generic and a lumbar disease-specific questionnaire.

METHODOLOGY

50 patients were evaluated (average age: 44.9 years; 52 male and 48 female). Two questionnaires were used for this purpose: the SF36 generic questionnaire, measuring eight quality of life domains divided into two sub-domains (overall physical and overall mental health), and the NASS LBP lumbar disease-specific questionnaire measuring four domains (pain and disability, motor and sensory neurogenic symptoms, expectations from the treatment and satisfaction with it). The results of the physical domain (SF36-PHYS) are low at the beginning of monitoring (25.7); they increase over the following 6 months (46.4) and drop insignificantly after 4 years (45.9). The mental health value (40.4) remained unchanged as compared to that of the general population. Values of the physical functioning domain reach that of the general population (80.0) after 6 months. Neurogenic symptoms domain results (NASS LBP-NS) do not correlate with other scales and domains. The conclusion is that the quality of life of patients after a lumbar microdiscectomy deteriorates significantly from a physical point of view immediately after it. It normalizes over the following 6 months, though a certain degree of physical damage still remains. Mental health alteration is not specific for lumbar radiculopathy. The neurogenic symptoms domain is the least improved dimension of their quality of life: it is very specific and to be evaluated with a special test set.

The quality of life of lumbar radiculopathy patients under conservative treatment

Background/Aim. The quality of life of lumbar radiculopathy patients conditioned by their health status is a result of both their subjective perception of the disease and their objective health status. The aim of this study was to evaluate the quality of life of lumbar radiculopathy patients under conservative treatment by means of generic and another lumbar syndrome specific questionnaires. Methods. A total of 50 patients (33 males, 17 females average age 46.1 years,) under conservative treatment in a hospital over four weeks were included in the study. They were interviewed using two questionnaires: the SF36 (Short form (36) Health Survey) generic questionnaire measuring eight domains of their quality of life summarized into two main ones (i.e. overall physical and overall mental health), and the lumbar syndrome specific North American Spine Society - Low Back Pain Outcome Instrument (NASS LBP), a questionnaire measuring four domains (functional limitations, motor and sensitive neurological symptoms, expectations from the treatment and satisfaction with it). Results. The values of physical health domain was low as 31.1 at the beginning of the treatment, were rising over the following six months and dropped insignificantly after four years (42.1/48.7 /47.0) The mental health values (47.2) did not alter as compared to that of the general population. A values of the quality of life stabilized within six months. The neurological symptoms domain did not correlate with other value scales and domains. Conclusion. The quality of life of lumbar radiculopathy patients was impaired only from its physical aspect, but after conservative treatment it improved over the following six months. After four years there is an insignificant drop of all quality of life values, indicating a need for a longer term monitoring of there patients.