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Preoperative motor deficit in lumbar disc herniation and its influence on quality of life

Déficit motor pré-operatório por hérnia de disco lombar e sua influência na qualidade de vida

Déficit motor preoperatorio por hernia de disco lumbar y su influencia en la calidad de vida

Objective:

Evaluate the impact of motor deficit (MD) on pain, disability, depression and quality of life measures of patients with LDH prior to a specific treatment.

Methods:

A total of 254 consecutively enrolled patients with LDH associated to neurological impairment and sciatica who have not responded to conservative treatment were evaluated. After reviewing the exclusion criteria, 168 were included. Validated instruments were used in the preoperative period to evaluate: pain, disability, quality of life, anxiety and depression.

Results:

Normal motor strength was observed in 57 (33.9%) patients and MD was observed in 111 (66.1%) cases. No statistically significant differences were observed between patients with and without MD regarding gender, age, level of herniation, lateralization and workers&apos; compensation. Regarding quality of life, no difference was detected in the eight domains of SF36 and between the PCS and MCS groups. The only difference observed was a higher disability rate in the MD group, with the mean ODI difference being 7.84 (CI 95%: 1.82â€"13.87; p=0.011). Motor weakness was observed in 35.1% (n=39/111) of patients who had abnormal results at the motor evaluation, being related to severity (X²: 46.058; p<0.0001).

Conclusion:

In patients with LDH without prior specific treatment, the presence of MD did not modify the pain, disability, depression measures and self-reported quality of life. The MD has no discriminative power for measures of quality of life in patients with LDH.

Intervertebral disc displacement; Lumbar vertebrae; Quality of life


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